Calm & Confident Childbirth                           with Katie Johnson
Average course fee: $250/couple

Private courses include 5, 2 hour class sessions, a student workbook, handouts, access to my online lectures, and a childbirth/pregnancy/parenting lending library. Your remaining balance is due by the end of the first class unless prior arrangements have been approved. All payments can be made by cash, check, Google Pay, or PayPal. There will be a $30 charge, plus any additional expenses incurred, for returned checks.
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How did you hear about my class? If you were referred, please let me know who to thank! *
Mom's full name *
Mom's phone *
Email address *
Coach's full name *
Coach's relationship to Mom *
Coach's phone *
Coach's email address (if he/she wants to receive info/handouts)
Address *
Estimated due date *
MM
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DD
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YYYY
Birth place (name of hospital or other location) *
Name of doctor or midwife *
Do you plan to hire a doula?
Do you already have children? *
Please tell me about your previous birth experience(s)
What do you hope to achieve by attending this class? *
Do you have any health concerns/pregnancy complications I should know about? *
Do you have any food allergies or sensitivities?
Please tell me anything else about yourself you would like me to know.
Payment method *
(after submission, payment instructions will be sent via email)
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