New Patient Appointment Request - Midwifery Care, Birth Center Delivery
WELCOME! If you would like to make an appointment please complete this form. Your information is confidential. We encourage you to correspond via email and text as our phone lines are extremely busy.

If you are interested in more information about our natural birth and water birthing services at The Birth Place we are happy to help you.

Please email Juana Duran on receptionist@thebirthplace.org

If you have an EMERGENCY please go to your nearest hospital or call 911.

Please check our website- www.thebirthplace.org and our Facebook page - https://www.facebook.com/thebirthplace

For more about our owner/founder and Clinical Director JENNIE JOSEPH - https://jenniejoseph.com

THANK YOU AND CONGRATULATIONS!
The Birth Place - JENNIE JOSEPH Clinical Director, Lead Midwife, Birth Center Founder and Owner - A JJ Way® Community-based Maternity center
The Birth Place - Birth Center, Winter Garden -CASSIE LARGAESPADA, Licensed Midwife
The Birth Place - Birth Center, Winter Garden -MARY SUPRENANT, Licensed Midwife
The Birth Place - Birth Center, Winter Garden -JUANA DURAN, financial coordinator and billing department
Next
Never submit passwords through Google Forms.
This form was created inside of Commonsense Childbirth - THE BIRTH PLACE Inc. Report Abuse