Request Midwife Care

Request midwifery care by filling out our intake form. If you are not comfortable with providing your information online please call us at 519-624-9708 or stop by our office as soon as you are aware you are pregnant.

Midwifery care in Ontario is in high demand but remains quite accessible. Some months are busier than others, and it is quite possible that a spot might be available to someone who wishes to access midwifery care later in their pregnancy.  Do not hesitate to get in touch with us if you would like to have a midwife.

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  • CURRENT PREGNANCY INFORMATION

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  • PAST PREGNANCY AND MEDICAL INFORMATION

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  • PARTNER INFORMATOIN (if applicable)

  • FAMILY DOCTOR/NURSE PRACTITIONER INFORMATION (if applicable)

  • FINAL QUESTIONS

  • Any information you provide will be stored in accordance with the privacy standards for Ontario (privacy code).