New Client Registration Form
Pre Registration is required to attend an Introductory Session. Please wait for a registration confirmation by email.
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Full Name *
Man's Name *
(married or engaged) If Single please type "Single"
Woman's Date of Birth *
MM
/
DD
/
YYYY
Address, City, ST, Zip Code *
Phone Number *
Email Address *
Referred by or How you Heard about Ashwood FertilityCare Center *
Name of Your Personal OB/GYN or Family Doctor *
Date of your last Pap Smear *
How would you describe your Reproductive Category? *
(Regular cycles, Long Cycles, Breastfeeding, Post -Pill, Pre menopause, Infertility, other)
I'm registered for the following FREE Introductory Session LIVE Webinar *
I/We would like to attend the Sessions: *
For Follow up appointments, I would prefer to work with the following FertilityCare Practitioner
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Do you have any questions for us regarding the Intro Session or beginning to learn the Creighton Model FertilityCare System?
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
Melissa Rupp, FCP meets with clients in Sanborn, IA and online
Ashley Paul, FCP meets with clients in Humboldt, IA and online
Lisa Willis, CFCP - Meets with clients in Sioux City, IA and online
Elizabeth Wessling, FCP - Meets with clients in Sioux City, IA and online

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:

Introductory Session is FREE to attend

$75.00 Registration/Materials Fee

$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)

I have read and agree with the above Important Information *
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