Childbirth Classes Registration & Interest Form
Thank you for your interest in our childbirth classes. This form is used to register for upcoming sessions and help us prepare for your attendance. Classes are offered in two 2.5-hour sessions. Session 1: Childbirth education and Session 2: Postpartum and newborn care. Classes are held on the first and third Wednesday of each month from 5 to 7:30 p.m. in the Port Room, second floor of the Medical Office Building at 4810 S Croatan Hwy, Nags Head, NC 27959. Please complete and submit this form to sign up for the class. If you have questions, please email emma.mcclain@outerbankshealth.org
Name
*
First Name
Last Name
Partner's Name (if attending)
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Estimated Due Date
*
-
Month
-
Day
Year
When are you expecting your baby?
Please select the dates you would like to attend from 5 p.m to 7:30 p.m. It is recommended to have completed the series prior to 36 weeks of pregnancy.
*
April 1 & April 15
May 6 & May 20
June 3 & June 17
July 1 & July 15
August 5 & August 19
September 2 & September 16
October 7 & October 21
November 4 & November 18
December 2 & December 16
Do you have any specific topics or questions you'd like covered?
Let us know your interests or concerns so we can tailor the sessions.
Do you or your partner have any special needs or accessibility requirements?
How did you hear about the class?
Healthcare Provider
Hospital Website
Social Media
Flyer
Friend or Family
Other
Submit
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