This is an IN PERSON class option, this class series will meet IN PERSON weekly on Detroit's westside.  If you think you cannot attend weekly in-person classes please consider one of our hybrid class options.

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* 1. Your first and last name:

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* 2. Support Person first and last name

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* 3. Will you be at least 25 weeks at the start date of the class series?

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* 4. When is your due date?

Date

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* 5. Where are you planning to give birth?

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* 6. Are you a Birth Detroit Care Client 

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* 7. What's your phone number?

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* 8. What's your email address?

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* 9. What's your address? (Include city, state, and zip code)

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* 10. What do you and your support person already know about 
pregnancy and childbirth?

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* 11. What type of learner(s) are you?

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* 12. What do you want to get most from your childbirth course? (Choose all that apply)

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* 13. Living into our values of safety, love, trust and justice, everyone is welcome to enroll in our courses.  To make the course accessible to everyone, we simply ask participants to email ELON@BIRTHDETROIT.COM if you are unable to afford our registration cost.

You will pay at the end of this survey.

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