If you would like to have midwifery care for this pregnancy please fill out the form below.  

Our Contact Information

Unit 203-3150 Island Hwy N, Nanaimo, BC
Phone: 250-741-1294 / Fax: 250-741-1293
admin@nanaimomidwives.ca

Intake Request Form

What are your pronouns





Have you previously had midwifery care?





If you have previouly had care with Nanaimo Registered Midwives do you have a preference for your care provider/s in this pregnancy? (This is ofcourse completely dependent on availability)




If you have given birth before, what type of birth did you have?





If we are unable to care for you for your entire pregnancy are you interested in postpartum only care? Postpartum care include home visits in the first week post partum so you and your baby do not have to go anywhere and can focus on resting, feeding and recovering from the birth. Clinic visits afterwards until 6 weeks postpartum. If this interests you and we have availability you can speak with your maternity care provider about transferring into midwifery care once your baby is born.




Privacy Policy:

We are committed to protecting your privacy and information. We will not distribute your email to any third parties without your permission, and will only use it for direct communications with you as needed. All your health information will be kept in the encrypted online server of our online medical record system.