Skip to content
Registration: Prenatal Education Key Messages Users
*
1.
First name
(Required.)
*
2.
Last name
(Required.)
*
3.
Email address
(Required.)
4.
Name of organization
*
5.
Address
(Required.)
*
6.
City
(Required.)
*
7.
Province
(Required.)
AB
BC
MB
NB
NL
NS
NT
NU
ON
PE
QC
SK
YT
Not applicable
*
8.
Country
(Required.)
Canada
Other (please specify)
*
9.
In what capacity do you provide universal prenatal health information (please check all that apply)
(Required.)
Public Health prenatal education program
Healthy Babies Healthy Children program
Canada Prenatal Nutrition program
Hospital-based prenatal education program
Private prenatal education program
Doula practice
Midwifery practice
Obstetrical practice
Family physician practice
Family Health Team practice
Online prenatal education
Other (please specify)
*
10.
What qualifications do you have related to providing universal prenatal health information? (Please check all that apply)
(Required.)
Registered Nurse
Nurse Practitioner
Public Health Nurse
Prenatal Education Certification
Doula Certification
Registered Midwife
Medical Doctor
Dietitian
Other (please specify)
