For more information
call:
Alicia Montgomery
CD(DONA)
Birthing From Within Mentor

248-930-4539
or
E-mail
Birthing From Within Registration Form
Class you are registering for
Class Date (for group class)
Your Name
Partner's Name
Your Due Date
Street Address
Apt
City
State
Zip Code
Home Phone
Cell Phone
Work Phone
Your E-mail
How did you hear about my classes?
Is this your first baby?
Which Childbirth books have you read?
Have you taken any other Childbirth Preparation Classes.  If so, which ones?
What led you to this Birthing From Within Class?
Tell me what you expect to gain from this class by the end?
Tell me about your pregnancy thus far.  This can be anything you think
relevant (positive/negative experiences, emotions, experience with your care
provider etc.)  Just tell me what you think about pregnancy – how has it been
for you?