Bondslane 產後紥肚服務轉介表格 Bondslane Maternity Limited- Postpartum Belly Wrapping Referral Request Form
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1. 如何稱呼你? How do we address you?  *
2. 你現在居於英國那一個城市? Which city do you live in the UK? *
3. 你的住址 What is your postcode? *
4. 聯絡方法 Contact method *
Required
5. 預產期或已分娩之日期 Your estimated date of confinement (EDC) or date of delivery *
MM
/
DD
/
YYYY
6. 計劃分娩方式或分娩方式 Planned method of delivery or method of delivery
Clear selection
7. 你現在有多少個孩子? How many children do you have before this gestation?
8. 你有沒有皮膚敏感? Do you have skin allergy?
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