Intake Form

Congratulations on your pregnancy!

Midwives are primary care providers who specialize in low risk pregnancy and birth.
In Ontario, you can choose to have a midwife or a doctor (OB/FP) look after you when you’re pregnant, but not both. This means that unless there is a complication, your midwife will provide all the care you need in office and at your hospital birth.
For more information please visit the AOM website.

If you would like to learn more about midwifery care please spend some time on our website, or speak with Fran or Pavneet our administrators. Due to our busy clinic schedule it is not possible to book an interview appointment with our midwives.

Intake Form
Length of cycle in days:
Medical History
Have you had any of the following done in this pregnancy?

The midwives discuss all possible intakes at our regular practice meeting on Tuesday afternoon. Our administrator will be in touch on Tuesday after the meeting to let you know if you have been accepted into care or added to our wait list.

If you have any questions or are having difficulty filling out the form please call our office during our regular business hour: Monday to Thursday 9am to 12pm & 1pm to 5pm.