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Minnesota Midwife Census
To get an accurate count, location and practice type of all the community midwives practicing in Minnesota
* Required
Full name
*
Your answer
Practice Name
*
Your answer
Practice office location
*
Your answer
Contact information phone address email etc. Please note best/preferred method of contact
*
Your answer
Route of Entry to Midwifery (credentials)
*
Your answer
How long have you been practicing
*
Your answer
Who did you train with? Schooling/training and preceptor(s)
*
Your answer
What area do you serve, how far do you travel?
*
Your answer
Are the majority of your births rural, suburban, urban?
*
Your answer
Do you work with apprenticing midwives?
*
Yes
No
I might consider it
Do you primarily serve a particular population?
*
Your answer
How can the midwife organization help you in your practice? ie: medical outreach, supplies, classes, et cetera
*
Your answer
At this point the intent is to keep this census information within the MMG organization. However, in the future would you prefer that your business contact information
*
Stay within MMG and NOT be shared anywhere
Shared with other midwives
Shared on the MMG website
Please contact me at the time and I will decide at that time
Date you completed this census
*
Your answer
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