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Client Intake Form

Please complete the following form so we can process your request and get started. Once completed we will be in touch as soon as we are able. If you don’t hear from us within a few days then please follow up with a phone call or direct message to ensure we received the application as expected.

The intake form should only be filled out by the clients seriously interested in midwifery care. Midwifery care is for low risk pregnancies.  If you have an inherited genetic or blood disorder or elevated BMI > 30 this may make you ineligible.  

There will be $50.00 registration fee per pregnancy at the first prenatal appointment! This is to cover extra services provided but not covered by the Medical Service Plan. If you have any questions please don’t hesitate to ask.

We see clients on Wednesdays and the clinic is situated in the building just beside the Sea Bus Terminal at the Lonsdale Quay.

Covid - Health & Safety

Please note that face masks are mandatory at all appointments.