Renew, Reclaim, Recharge Booking Form

  • Renew, Reclaim, Recharge Booking Form

    BREATHE Midwives Focusing on Supporting BIPOC Health and Wellness:

  • Lets make self-care a priority!

    Welcome. We are so excited to be offering this service. Please book a massage below for yourself, your little one or both of you. This is open to young and young at heart!

    Please note to allow everyone the opportunity to have access to a massage, we are limiting one massage per our Renew, Reclaim, Recharge series. We hope to be able to expand this service in the near future.

    Individuals who identify as African, Black, and/or Black-Caribbean will be given high priority. Individuals who identity as IPOC may access the services.

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  • Who is the appointment for?
  • Have you or your child had a massage at BREATHE Midwives before?*
  • Has your situation change since the last session (i.e., you were pregnant but now have given birth)*
  • What is your current situation?*
  • Has your baby/child situation change since the last session (i.e., was 0-3 months but now is 3 to 12 months)*
  • What is your baby's current situation?*
  • Select an Appointment Date*

  • Your Information

  • Format: (000) 000-0000.
  • Should be Empty: