SLHD - Canterbury Hospital - Expression of Interest Form

Canterbury Hospital

Canterbury Hospital
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Expression of Interest Form - Parent Education classes

Required Fields: *

Please complete the below form to express your interest in the Childbirth and Parenting Program offered at Canterbury Hospital. You will then receive an email outlining your options.
Today's date: 24/May/2026

First Name: *

Last Name: *

Date of Birth (DOB): *

Support Person/ Partner First Name:

Support Person/ Partner Last Name:

Address: *

Email: *

Mobile: *

Do you have Medicare? *

Yes No

Due Date(EDC): *

Are you having your baby at Canterbury Hospital? *

Yes No Other

Other:

Who will you be seeing for your maternity care? *

Midwives Clinic
CAPS
Midwifery Group Practice
GP Share Care
Obstetrician

Comments:

I'm not a robot