River Valley Birth Center Orientation Registration
If you are interested in starting care with River Valley Birth Center or are just interested in learning more about the care we offer, the first step is to attend an orientation session. These sessions are held virtually via Zoom. We request that people mute their microphones, but feel free to have your camera on as it is lovely to get to see some faces as we cover the information and help you decide if birth center care is right for you!
After you register on this form, you will get an email confirming your registration. Stay on the look out for an email invite to the Zoom meeting, typically we send those out just a few hours before the start time.
While we require contact information for each registrant, we will not sell or share you information. We also will not add anyone to mailing lists or hassle you in any way! We want for you to be able to find out about our practice and services without any pressure or obligations.
Questions? Contact us at (507)934-1565
* Required
Email address
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Your email
Name (first and last)
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Your answer
Cell phone number (in the event we must cancel)
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Your answer
Home or mailing address
Your answer
Due Date (it is ok to estimate)
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Your answer
Where did you hear about us?
Your answer
Are there any specific topics or questions you are hoping we will cover during this session?
Your answer
We have information we send to families regarding insurance and billing, depending on your coverage. In order to serve you best with the relevant forms, it is helpful if you don't mind sharing this information with us in advance.
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Commercial Health Insurance- Insurance through work, self-purchased, a spouse, or parent.
Minnesota Health Care Plans- Medicaid including BluePlus, UCare, South Country Health Alliance, or straight Medicaid through the state.
Tricare
VA insurance
Health Share- Examples include: Samaritan Ministries, Medi-share, Liberty Health Share, Christian Health, etc.
Self pay. I have no insurance or health share and do not intend to get coverage prior to the birth. I do not qualify for state insurance such as Medicaid.
Not sure/prefer to not disclose
Other:
Which orientation date will you attend?
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January 22, 2021 at 6:00pm
February 5, 2021 at 6:00pm
February 19, 2021 at 6:00pm
I need assistance scheduling due to obligations that cannot be adjusted.
Required
A copy of your responses will be emailed to the address you provided.
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