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Australia's most highly acclaimed and trusted childbirth education program

Selected course

Calmbirth in Berry, NSW with Regina Power,
Suite 6, 98 Queen Street, Berry NSW 2535 9:00am - 5:30pm

Regina Power

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Ticket Type

1x ticket = 2 people or 1 couple

Full Payment
For you and your partner to attend the course for the above date.

$550

Regina Power

Regina Power

  • M.ED Counselling and Certified Doula
  • Suite 6, 98 Queen Street, Berry NSW 2535 9:00am - 5:30pm
  • 14/09/19 and 15/09/19
    9:00am - 5:30pm
Required
Mother's first name *
Mother's last name *
Partner’s/Support Person’s Name *
Address *
City/Town *
State *
Post Code *
PHONE *
Email *
Ensure you will be able to receive emails post birth, by using a non work related email address
Personal Questions
Mother’s occupation
Partner’s occupation
Health Fund NAME
Do either of you have 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 first child?
Due Date
Model of Care
Name of Caregiver
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?
How did you hear about Calmbirth Classes?
Do you give permission to Calmbirth to use any of your photos, testimonials and birth stories for print and online marketing?

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