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My Midwives Client Information Form

My Midwives Client Information Form

To proceed with your Medicare Bulk Billed postnatal care with My Midwives, we need to collect some information first. Please complete this form in its entirety, it may take 5-10 minutes. You will need your Medicare Card number to complete this form. Please note that if you are not eligible for Medicare, you will not be able to complete this form or receive Bulk Billed postnatal care.
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    Please list your full address, including your suburb, state and postcode
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    • Brisbane
    • Toowoomba
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    Number of pregnancies you have had including miscarriages & terminations
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    Number of births you have had
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    GP Share Care, Hospital MGP, Obstetric Care, Midwifery COC etc.
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    Please Select
    • Spontaneous Vaginal Birth
    • Spontaneous Vaginal Birth - VBAC
    • Forceps
    • Vacuum
    • Elective C-Section
    • Emergency C-Section
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    Please Select
    • Exclusively Breastfeeding
    • Expressed Breast Milk
    • Formula
    • Combination (Breastmilk and Formula)
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