1:1 Education Request

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Please fill out the questions below and I will be in touch to book your 1:1 education.

Name *

Phone number or Email *

Due Date *

YYYY

Which 1:1 education class would you like to book? *

Custom Prenatal Class (3 hours)

Specialized Education Classes (1-2 hours)

I'm not sure and would like to chat to decide

If you are interested in a specialized education class, which one would you like to book? (Choose as many as you are interested in)

Induced Labour Class

Unmedicated Delivery Class

Epidural Delivery Class

Caesarean Birth Class

Postpartum & Newborn Class

Feeding Education

Best time for a return call *

Morning (9-12)

Afternoon (12-4pm)

Evening (4-8pm)

Weekday

Weekend

Other:

Required

Is there anything you would like me to know before we chat?

How did you hear about my services?

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