Apply for Midwifery care
If you'd like to apply for midwifery care, please fill out the form below.
Preferred Name (What do you like to be called? If you have a preferred pronoun, you can also add that here.)
Full Name (First, Middle, Last - as it appears on your BC Services Card)
Age at Estimated Date of Delivery
Apartment, Suite, etc.
Which is the best way to contact you during the day?
Is it okay to leave a message at this number?
Partner's Full Name (if applicable)
Partner's Phone Number
Family Doctor's Name
First day of your last menstrual period:
Estimated Date of Delivery (Need help? Copy and paste the following link) http://www.perinatalservicesbc.ca/health-professionals/professional-resources/edd-calculator
Have you seen a doctor at all this pregnancy? What have they ordered?
I haven't seen a doctor
Is this your first baby?
If no, how many times have you given birth vaginally?
If no, how many times have you given birth by cesarean?
Please share about your previous birth experience, if applicable:
Registered midwives attend births in hospital and at home. Where are you planning to have this baby?
Have you had previous midwifery care?
If yes, which practice?
Was a midwife from Sage Hills Community Midwives in attendance at any prior births? If so, who?
Do you have any of the following:
None of the above
Why are you interested in Midwifery care?
Contact Us Today
If you wish to apply for Midwifery Care please click the 'Apply now' button above. For all other enquiries please send us an email.
#208-300 Columbia St.
Kamloops, BC V2C 6L1
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