Fika Midwifery Home Birth Kit Order Form
The home birth kit includes everything you need for your home birth. You will be billed $150 for these supplies once you fill out the form, and we will distribute your birth tub and home birth supply kit to you between 36-38 weeks of pregnancy.
Email address *
Name *
Your answer
Due Date *
Mattress Cover Size *
Depends Size *
Are you renting a tub and associated water birth supplies from Fika Midwifery? (Cost: $200 for tub, disposable liner, lead-free hose, water bandit to hook up hose to faucet, thermometer, fish net) *
If you are renting a tub, what size hose do you need (please measure or pick the larger size if you are unsure!)
Would you like to have any optional add-ons added to your kit?
Never submit passwords through Google Forms.
This form was created inside of Fika Midwifery. Report Abuse - Terms of Service