New Patient Prenatal Intake Form
Congratulations on your pregnancy!
We look forward to welcoming you to our practice for full scope midwifery care (prenatal, labour and birth, and postpartum). If you are looking for the Postpartum Intake Form, please click here.
We collect this information to assist us in preparing to provide you with the best possible care for your pregnancy and birth. Please tell us as much or as little as you feel comfortable. We will discuss this form with you on your first visit, so please send us this form in order to book your first visit. You will receive a reply via email within 3-5 days of submission.
We recommend you use Google Chrome as your browser when completing this intake form as we have had issues with other browsers not sending the form correctly to us for triaging. If you do not receive a reply within 1 week of sending your request, we recommend sending in a new form.
We do accept a few private-pay patients each month who need our services. Please ensure you answer the question: “Do you have a BC Care Card?” accurately so that we can assess whether we have space for you to enter our care as a private pay patient.
PLEASE CHECK YOUR JUNK MAIL FOLDER. Depending on your email settings, our “Welcome Email” can sometimes end up in your junk folder. If we do not receive a reply to this initial email within 1 week of sending, we will close your file. So please check your spam regularly while waiting for us to contact you.
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