Question Title

* 1. Your first and last name:

Question Title

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

Question Title

* 3. When is your due date?

Date

Question Title

* 4. Where are you planning to give birth?

Question Title

* 5. Are you a Birth Detroit Care Client 

Question Title

* 6. What's your phone number?

Question Title

* 7. What's your email address?

Question Title

* 8. What's the best way to communicate with you? (Choose all that apply)

Question Title

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

Question Title

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

Question Title

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

Question Title

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

Question Title

* 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.

T