SBJN - Mobile Midwife Clinic Interest Form

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The purpose of this form is to gather information about the general interest in the Mobile Midwife Clinic and Southern Birth Justice Network.

Southern Birth Justice Network (SBJN) is a 501(c)3 non-profit organization whose mission is to expand Birth Justice by using storytelling, popular education, and community organizing to improve access to midwifery and doula care.

The Mobile Midwife Clinic provides accessible and culturally congruent prenatal health care services to various communities throughout Miami-Dade County, reducing traditional barriers to access such as transportation, time constraints, and distrust of the healthcare system.

Services include:

Initial prenatal screenings with referral to Midwifery and/or OBGYN care

Doula Services

Health education (Specifically childbirth and breastfeeding education)

Family Planning

Referral to social services

Screening for Sexually Transmitted Infections and COVID-19

Collecting birth stories to identify gaps in health care needs

Postpartum health screenings and referrals (including lactation support)

Wraparound services

For Clinic days, Appointments preferred!

Walks Ins are welcomed!

Upcoming clinic dates & location: (TBD)

If you have any questions, comments or concerns, email us at mobilemidwife@southernbirthjustice.org

Email *

Name *

Email *

Phone number *

Residential Zip Code *

Which of the following best describes your interest? Select all that apply. *

I am a person seeking care from the Mobile Midwife Clinic (Prenatal, Postpartum, Referral to Social Services, STD/HIV Testing and etc...)

I am interested in partnering with the Mobile Midwife Clinic.

I am part of a community organization.

I am interested in becoming a site for the Mobile Midwife Clinic.

I would like to donate to the Mobile Midwife Clinic

I would like to volunteer with the Mobile Midwife Clinic

I am a community member. I would like to get more information about Mobile Midwife Clinic.

Other:

Required

Where in Miami Dade County would you suggest the Mobile Midwife Clinic visit next? *

Are you interested in receiving more information about Southern Birth Justice Network other programs? *

Yes

Other:

Please add any questions or comments here.

A copy of your responses will be emailed to the address you provided.

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