Empower Choice Pregnancy Class
Empower House Community Health Workers facilitate evidence-based classes on healthy pregnancy. To support healthy pregnancy education, EHSA utilizes "Becoming A Mom,” a culturally relevant curriculum from the March of Dimes, designed to empower expectant parents with the knowledge and skills necessary for a healthy pregnancy.
Empower House and YWCA Collaboration
Thank you for your interest in the Healthy Moms Cohort, a free 10-week maternal health and life skills program designed to support pregnant and postpartum women on their journey toward healthier pregnancies, confident parenting, and family wellness.Through our partnership with the YWCA, participants will receive education, resources, and hands-on learning opportunities that promote healthy outcomes for moms and babies while building practical life skills for everyday success. Program Benefits: • Weekly interactive workshops• Hands-on life skills training• Maternal health education• Community resources and referrals• Opportunities to connect with other mothers• Participant workbook and educational materials• Graduation certificate upon completion
Eligibility:
In
1st or early 2nd Trimester (up to 27 weeks)
upon entering the program
Resident of Bexar County
Cohort Start Dates
*
Tuesday, September 8th (HYBRID) @ 6p - 8p; Empower House SA, 200 Donaldson Ave. (Not affiliated with YWCA)
Wednesday, October 7th (NOT HYBRID) 10a -12p Lockwood 801 N. Olive SA TX 78202
Put me on the waitlist
Would you be attending in person or virtual?
*
In person
Virtual (Zoom)
If attending in person, would you need transportation?
Yes
No
Name
*
First Name/1er Nombre
Last Name/Apellido
E-mail
*
example@example.com
Phone Number
*
Format: (000) 000-0000.
Preferred Method of Contact
*
Please Select
Phone call
Text Message
Email
Address
*
Street Address/Dirección o número de calle y apartamento si aplica
City/Ciudad
State / Province-Estado/Provincia
Zipcode/Código postal
How did you hear about Empower House?
*
Please Select
YWCA
Referral
Community Member
Instagram
Facebook
Community Event
Empower House Staff
Empower House Radio 101.5
Internet Search
Other
If you selected referral: Who referred you?
Upon enrollment, you are automatically eligible for the services below. What other services would you be interested in:
*
Mental Health Counseling
Benefits Counseling (Applying for SNAP, WIC, Medicaid, etc...)
Doula Services
Basic Needs (Rental Assistance, CPS, SAWS, Crib, Car seat, Diapers)
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Availability
What days of the week would you be available to attend class? (check all that apply)
*
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
What times would you be available to meet for class? (check all that apply)
*
Mornings (9-12)
Afternoons (12-5)
Evenings (5-8)
How would you be able to attend class? (check all that apply)
*
In-person
Via Zoom/Teams
In-person (if childcare is provided)
In-person (if transportation support is provided)
Additional Availability Comments
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Demographics and Prenatal Care
Due Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Have you seen an Ob-Gyn/Medical Provider?
*
Please Select
Yes
No
Date of first visit with Ob-Gyn/Medical Provider
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Name of Ob-Gyn/Medical Provider
Medical Provider Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Insurance Provider
*
Preferred Language
*
English
Spanish
Other
Your Birthdate
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Gender
*
Please Select
woman/girl
man/boy
genderfluid
non-binary
transgender woman
transgender man
prefer not to answer
none of the above
Ethnicity
*
Please Select
American Indian or Alaskan Native
Asian
Black or African American
Native Hawaiian or other Pacific Islander
White
Hispanic/Latinx
More than one of the above
None of the above
Decline to answer
Hispanic or Latino Origin
*
Please Select
Hispanic or Latino Origin
Non Hispanic or Latino Origin
Prefer not to answer
Education/Educación
*
Please Select
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
10th grade
11th grade
12th grade but did not graduate/ No terminó la preparatoria
high school diploma/ Graduado de Preparatoria
GED/ Recibió GED
technical degree/Carrera Técnica
some college no degree/ Algunos estudios universitarios
Associates degree/grado Asociado
Bachelors degree/título de grado
Graduate or professional degree/ Posgrado - Maestría o Doctorado
Prefer not to answer/se niega a responder
Military Affiliation
*
Please Select
Never Served in the military
Active Duty
Reserve or National Guard
Veteran
Retired (Military)
Military Dependent (Spouses, children)
Number of other children
*
Ages of other children
*
Household Composition (who lives in the home)
*
Please Select
single parent/caregiver family (no grandparents present)
two-parent/caregiver family (no grandparents present)
single parent/caregiver family with grandparent(s) present
family with grandparent(s) responsible for grandchild(ren)
other family composition
single person (without family)
Other non-family household (other than single person)
Total number of people in your household
*
Monthly Household Income
*
Submit
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