Intake Form

We will respond to you to confirm receipt of your intake form at the email address you provide. If you do not receive that confirmation email in ten business days, please check your spam/junk mail, or follow up at 1-833-687-6333 or

Ideally we would take into care every woman who wanted a midwife. Realistically, we have limitations due to the number of midwives available and the number of births allowed by the MOHLTC.

Our administrator will contact you within ten business days to let you know if we can accommodate you.

Fields marked with an * are required.

Use this tool below to calculate your due date, then enter in the intake form below.

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