Client Intake Form

Vera and her colleagues support a woman’s choice to plan her birth in the hospital or at home, and to create a beautiful and empowering experience. We are committed to providing a personalized service during pregnancy, labor and postpartum. We would be happy to discuss midwifery services or answer any questions you may have. You can leave us a message either using our contact form, or by telephoning us at 604 984 6960, and we’ll get back to you.

If you wish to discuss your queries in person, you can fill in our Client Intake Form below, we’ll arrange an appointment during your indicated preferred time and confirm this date and time with you by email. To submit the form all the starred boxes must be completed.

Please note: We are currently booking clients that are due February 2018 and onwards.  Occasionally a spot becomes available in an earlier month – regardless of due date – women interested in midwifery services are encouraged to ask – Telephone 604 984 6960 or email us here and Jazzmin Nagy, Vera’s office assistant will respond to your query.  Returning clients get preference, we love to see you back!