Midwifery
Please complete and bring to our first visit:
Hiring Agreement
Informed Choice Disclosure
Financial Agreement
Emergency Transport Plan
Privacy and Protected Health Information
High Risk Pregnancy Disclosures
Please read the following:
Virginia Regulations for Licensed Midwives
Then print and sign this statement:
Virginia Licensed Midwife Regulatory Disclosure
Doula
Please complete and bring to our first visit:
Birth Doula Hiring Form
Postpartum Doula Hiring Form
Privacy and Protected Health Information
Maya Abdominal Therapy
Please complete and bring to our visit:
Health History Form
Privacy and Protected Health Information
Additional Forms
“Regardless of when or where or how you birth your baby…your journey matters. Your love, your courage, and your strength are worth celebrating.”
Monet Moutrie
