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Which course have you booked on to? (Please include course location and staff member - if known)
Your Name
Mobile Number
Partner's Name (or Birth Partner)
Partner's Mobile Number
Email Address
Address
When is your baby (babies) due and which course* have you joined?
*Max course attendees will be 5 couples/minimum 2 couples
Hospital/Birth Unit you plan to give birth at (if not applicable please state Homebirth/Other):
Midwife & GP surgery:
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