Book via our form below – doulacheriechugg.com

Join us

Classes are either two full days or four evenings, if you enquire early enough there is a chance dates can be moved to suit you.

Choose your class

Mother's full name

Partner's/support person's name

Address (including postcode)

Phone

Your E-Mail

Mother's occupation

Partner's Occupation

Health fund

Dietary requirements (please specify)

How did you hear about Calmbirth?

Do either of you have any specific fears or phobias (e.g. water, heights, etc.)?

Are you or your partner currently being treated for any medical or psychological issues? If you are under the care of a psychologist or psychiatrist, please provide a letter of approval for you to attend the Calmbirth course.

Do you take medication/s on a regular basis? If yes, what medications do you take?

Is this the birth of your

Due date

Healthcare model

Name of caregiver/s

Plan to birth at:

What are your feelings about the birth prior to commencement of the Calmbirth® class? Is there any specific fear you have regarding the birth or becoming a parent?

What would you like to get out of the Calmbirth program?

Do you give permission to Calmbirth to use any of your photos, testimonials and birth stories for print and online marketing?YesNo

Disclaimer: The Calmbirth® class program includes psychological & emotional preparation for birth. I understand that the delivery of the course will include guided relaxation as a means to facilitate emotional subconscious healing of fear and anxiety about childbirth.Yes