Register for classes

By phone:
303-642-5123

By Mail:
With Women, LLC
P.O. Box 325
Arvada, CO 80001

Or by email

Your name:
Your e-mail:
Phone number:
Estimated due date:
Have you given birth before? How many births (vaginal or c/s) and when?:
How many weeks pregnant are you now?:
Have you attended other childbirth preparation classes? If so, which?:


I would like private classes.
I would like to register for group classes.

Have you had any experience with meditation techniques? If so, which?:

Why are you attending this program?
 

Who is your care provider and where will you be giving birth?

Anything else you would like to share?

Thank you for taking the time to submit this form!


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