Faith Based Community Child Birth Education Course
By New Eden Birth and Wellness and The Birthing Bee
Thank you for your interest in our Faith-Based and Community-Centered Childbirth Education Course!
We believe birth is sacred, and we’re honored to walk alongside you in this season. Please complete the form below so we can get to know you, your goals, and how to best serve and support you. Classes will take place every Saturday from 10:00 AM – 12:00 PM and will be recorded. Once this form is submitted, you will receive a payment link to secure your spot.
Name
First Name
Last Name
Birth Partner's Name
First Name
Last Name
Will your birth partner or support person attend with you?
Yes
No
Sometimes
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Time Zone
Eastern
Central
Mountain
Pacific
Other
Back
Next
Are you currently pregnant?
Yes
No
Trying to conceive
Other
Estimated Due Date
-
Month
-
Day
Year
Date
Number of previous births?
Preferred Birth Setting
Home
Birth Center
Hospital
Unsure
Type of Provider
Midwife
OBGYN
In search
Are you a client of New Eden Birth and Wellness or The Birthing Bee Womb Wellness Services?
Yes
No
Do you have a doula?
Yes
No
In search
Back
Next
Have you previously taken a CBE course?
Yes
No
How do you learn best?
Visual
Discussion
Journaling and reflection
Homework
Will you be attending live or watching replays mostly?
Live
Watching Replays
Both
Are you comfortable sharing in a group setting?
Yes
No
Do you have a birth plan?
Yes
No
Back
Next
Why did you decide to enroll in this course?
What are you hoping to gain or fell more confident about by the end?
What are your biggest fears or concerns about birth right now?
What does a "successful birth? look like to you?
How would you describe your faith/spiritual background?
Christian
Spiritual but no religious
Other
Would you like prayer or spiritual encouragement as part of this course?
Yes
No
Are there any spiritual or emotional wounds around pregnancy loss or birth that you want held gently in this space?
If you could speak one prayer over your pregnancy and birth, what would it be?
Do you agree to honor confidentiality and hol others' stories with care?
Yes
No
Submit
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