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INTAKE FORM
We would love to hear from you. Please fill out this form and we'll be in touch.
If you do not receive a reply within 72 hours, please call us at 778-351-4441 or email dandelionmidwifery@gmail.com
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On your first visit, we will need your full name as it appears on your BC Medical Card, and your PHN.
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Please tell us; the first day of your last period, your estimated due date, previous number of pregnancies, Date of Birth and Public Health Number
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Calculate your Last Menstrual Period or Date of Delivery https://bit.ly/2A9nWZN
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Welcome
Services
About
Contact
Resources