COMMUNITY MIDWIVES OF BRANTFORD
  • Intake Form
  • About Us
    • Our Midwives
    • Birth Stories
    • Location
    • Contact
    • Student Evaluation
  • What is Midwifery?
  • Pregnancy
    • Pregnancy Care for Clients
    • When to Call your Midwife
    • Working with Students
    • Pregnancy Resources
    • Booklist
    • Crisis Lines
  • Birth
    • Home and Hospital Birth
    • Midwifery Care During Birth
    • Preparing for Birth
  • Postpartum
    • Care for Clients After Birth
    • Care for the Newborn
    • When to Call Your Midwife
    • Breastfeeding
    • Leaving Midwifery Care
    • Midwifery Care Evaluation Form

Intake Form

    If you would like to request care from our midwives, please fill out this form in its entirety. Fields indicated by a red star are required. Your request will be sent directly to us and our support staff will contact you if we are able to provide you with care.

    If you would prefer to provide your details by phone or are experiencing difficulty with this form please feel free to contact us at: 519-751-6444.

    Please calculate your estimated due date here before completing the form below.
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    Need help calculating your due date?

    When was the first day of your most recent menstrual period (LMP)? Please note that we are unable to process your form without an LMP or due date.













Submit
Community Midwives of Brantford

​217 Terrace Hill Street, Suite 100,
​Brantford, ON
N3R 1G8
Email: CMOBon98@gmail.com
Telephone: (519) 751-6444
Pager: 
1-888-257-4070
Fax: (519) 751-9196



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  • Intake Form
  • About Us
    • Our Midwives
    • Birth Stories
    • Location
    • Contact
    • Student Evaluation
  • What is Midwifery?
  • Pregnancy
    • Pregnancy Care for Clients
    • When to Call your Midwife
    • Working with Students
    • Pregnancy Resources
    • Booklist
    • Crisis Lines
  • Birth
    • Home and Hospital Birth
    • Midwifery Care During Birth
    • Preparing for Birth
  • Postpartum
    • Care for Clients After Birth
    • Care for the Newborn
    • When to Call Your Midwife
    • Breastfeeding
    • Leaving Midwifery Care
    • Midwifery Care Evaluation Form