Introductory Session Registration Form
Pre Registration is required to attend an Introductory Session. Please wait for a registration confirmation by email.
Full Name *
Your answer
Man's Name *
(married or engaged) If Single please type "Single"
Your answer
Woman's Date of Birth *
MM
/
DD
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YYYY
Address, City, ST, Zip Code *
Your answer
Phone Number *
Your answer
Email Address *
Your answer
Referred by or How you Heard about OC FertilityCare Center *
Your answer
Name of Your Personal OB/GYN or Family Doctor *
Your answer
Date of your last Pap Smear *
Your answer
How would you describe your Reproductive Category? *
(Regular cycles, Long Cycles, Breastfeeding, Post -Pill, Pre menopause, Infertility, other)
Your answer
I would like to Register for the following Introductory Session ($75). Small Business Saturday Sale on now until December 15th. Prepaid Intro sessions in Orange City - $25 off. prepaid Intro Sessions in Sanborn and Eagle Lake - $50 off. Prepay by December 15th and Register for any Intro Session scheduled. *
I/We will attend the Intro Session: *
For Follow up appointments, I would prefer to work with the following FertilityCare Practitioner
Do you have any questions for us regarding the Intro Session or beginning to learn the Creighton Model FertilityCare System?
Your answer
Important Information - Please Read before submitting form

Learning the CREIGHTON MODEL FertilityCare™ System begins with a one-hour group introductory session which explains the scientific foundations, methodology, application to various reproductive categories, how to make observations and how to keep a chart. You will gain an even deeper understanding at individualized, private follow-up sessions.

After learning to chart according to the CREIGHTON MODEL Fertility Care™ System, the new women’s reproductive health science, NaProTECHNOLOGY, can be applied to correct many health problems experienced by women.

After the Introductory Session, you will have individualized follow-up sessions. Each Session is about 60 minutes.

Kari Beadner, CFCP meets with clients in Orange City, IA and online
Kaleigh Van Middendorp, FCP meets with clients Hull, IA and online
Melissa Rupp, FCPI meets with clients in Sanborn, IA
Ashley Paul, FCPI meets with clients in Eagle Lake, MN

To adequately and confidently learn the system, the recommended follow-up schedule is 2, 4, 6, 8, 12 weeks then 6, 9 and 12 months from the Intro Session. (Total of 8 sessions in a year). It is highly recommended that couples attend the Introductory Session and Follow-Ups together.

The CREIGHTON MODEL FertilityCare™ System may not be learned adequately without follow up with a FertilityCare Practitioner. Therefore materials may not be purchased without scheduled follow up appointments. Materials must be returned if follow-ups discontinue before the 3rd follow up with a partial refund.

As a courtesy to your FertilityCare Practitioner and other clients, you must provide at least 48-hour notice if you need to reschedule your follow up appointment. If you fail to provide this 48-hour notice, a $20 rescheduling fee will be assessed.

Fees for FertilityCare Services

The CREIGHTON MODEL FertilityCare™ System consists of 1 year of teaching:
$75.00 for the Introductory Session - includes 1 year of charting materials

$60.00 per follow-up session (8 in the year)

The Full Program may be purchased for $525.00
(includes Intro Session, materials and first 8 follow up appointments)

Small Business Saturday Sale: November 30th -l December 15th - Prepay for any Orange City Intro Session for $25 off! Prepaid Intro Sessions in Sanborn, IA and Eagle Lake, MN are $50 off! limited to space. Prepay at paypal.me/ocfertilitycare after submitting this form.

I have read the above Important Information *
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