Private Booking Request Form

First name

Last name

Phone

Address

When is your expected due date?

What dates are you looking to book in for your private class?

Classes run for 8hrs total. E.g., 2 sessions x 4hrs or 4 evenings x 2hrs. Other arrangements available.

What is your current/past occupation?

Will a partner or support person be attending the class with you?

Yes

What is your support person's name?

What is your support person's current/past occupation?

Who is your primary care provider (if you have one)?

Where do you plan on giving birth?

Do you have any medical conditions or pregnancy complications?

What are your main goals for attending this class?

Are there specific topics you're particularly interested in?

Do you have any concerns or fears about childbirth you would like to address?

Please share any additional information that could assist in maximising your class experience.

Sacred Six Birth Education