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Hands and Hearts Birth & Botanical
Please answer every question that applies to your Inquiry. There are questions for Midwifery Support, Homeopathy Support, and Lab Review Support.
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First Name
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Last Name
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Email
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Phone Number
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How did you hear about us?
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What services are you interested in?
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Midwifery Care for Prenatal and Homebirth
Prenatal or Postpartum Support -- I intend to have a hospital birth
Homeopathy Consult
Functional Lab Review or Draw
MIDWIFERY CLIENTS:
Are you within a 90 mile radius of Corinth MS? What city do you live in?
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MIDWIFERY CLIENTS:
When is your estimated due date?
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MIDWIFERY CLIENTS:
What number pregnancy is this for you?
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MIDWIFERY CLIENTS:
Have you experiences any previous pregnancy, birth, or postpartum complications? (miscarriage/date, blood pressure, diabetes, etc)
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MIDWIFERY CLIENTS:
Tell us why you are interested in midwifery support and/or home birth (in general)
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LAB CLIENTS:
We require your existing lab reports be emailed in prior to your visit. Can you access these and send them?
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No
No, but I have paper copies to bring with me
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LAB CLIENTS:
Lab Visits are $25 plus the costs of the individual labs or blood panel bundles. Payment is due at your visit. Please mark that you understand. (Venmo, Cash app, Cash, Debit or Credit accepted)
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No
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HOMEOPATHY CLIENTS:
How familiar are you with homeopathic remedies and how they work?
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HOMEOPATHY CLIENTS:
Visits are $25 plus the costs of the remedies given. Payment is due at your visit. Please mark that you understand. (Venmo, Cash app, Cash, Debit or Credit accepted)
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We will do our best to get back with you as soon as possible. Please be aware this may take a few days if you have reached out over the weekend or we are attending a birth.
Would you prefer an email, text or phone call?
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