Client Registration

To register with Kawartha Community Midwives please fill in the information in the Client Registration form. This form is protected with a security certificate issued by thawte, Inc. so that all the information sent through the form is encrypted and can only be accessed by Kawartha Community Midwives.

Please note that completion of the Client Registration form does not guarantee Midwifery Care. After submitting the completed form someone from our office will call you within 7 business days.

Contact Information
Birth Information
This field is generated automatically based on a 28 day menstrual cycle. Though it can be adjusted manually, this date will be discussed with your midwife at the first visit.
Additional Information

Completion of the Client Registration form does not guarantee Midwifery Care. Someone from our office will call you within 7 business days.

© Kawartha Community Midwives

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