Welcome Back Alumni

Welcome back, mama.

You have walked these halls and made some incredible memories in these rooms. Welcome back, and congratulations on your growing family!

What may have changed since you were here last…

Have you seen our new birth pool?

The Contemporary Room was remodeled in 2021 with a larger, state-of-the-art active birth pool. This birth pool allows for deeper submersion and a wider variety of birthing positions.

Meet the new staff!

We have welcomed new midwifes, receptionists, and educators onto our team. Meet them Here!

Your next steps…

1. Check out our new Prenatal Nutrition Class series. We ask all clients to take Prenatal Nutrition as early as possible to set yourself up for a healthy pregnancy. This class is free and offered virtually. Sign up here.

2. Request an appointment by filling out the form below. We do ask that you use this form to update personal and insurance information. Someone will be in touch to schedule you soon.

3. Reach out to us with any questions or concerns. You can call us at 913-735-4888.

Fill out this form to Request An Appointment:

We will be in touch to schedule your appointment soon.

Alumni Demographics 2023

Client Information
Name*
First Middle Last
Maiden name - nickname
Maiden Name Nickname
Email*
Phone*
Date of Birth*
MM slash DD slash YYYY
Address*
Street Address City, State ZIP / Postal Code
Emergency Contacts
Emergency Contact(1) Name*
Relationship to Client*
Phone*
Emergency Contact(2) Name*
Relationship to Client*
Phone*
Insurance
Payment Method*
Kindly upload a picture of the FRONT of your insurance card
Drop files here or

Accepted file types: jpg, jpeg, png, gif, tiff, pdf, doc, docx, Max. file size: 50 MB.
Kindly upload a picture of the BACK of your insurance card
Drop files here or

Accepted file types: jpg, jpeg, png, gif, tiff, pdf, doc, docx, Max. file size: 50 MB.
Kindly upload a picture of your Driver's License:
Drop files here or

Accepted file types: jpg, jpeg, png, gif, tiff, pdf, doc, docx, Max. file size: 50 MB.
(Insurance) Name of Plan
Amount of Deductible/Coinsurance
Is someone other than you the primary insurance plan sponsor?*
- Yes
- No
Name the Employer, Federal Exchange, or state sponsoring insurance plan if someone other than yourself*
Name of Person*
Phone*
Relation*
Birth Date*
MM slash DD slash YYYY
Address*
Street Address City, State ZIP / Postal Code
Preferred Pharmacy Location
Name*
Address/Phone*
Tell Us About You
Are you currently pregnant?*
- Yes
- No
If yes, when are you due?*
How many children have you given birth to?*
Have you ever had any cesareans (C-Section)?*
- Yes
- No
If yes, please explain*
Other:*
Race*
Ethnicity*
Preferred Language*
Marital Status*
Faith/Cultural considerations you would like us to consider:
CAPTCHA

Welcome back, mama.

What may have changed since you were here last…

The Contemporary Room was remodeled in 2021 with a larger, state-of-the-art active birth pool. This birth pool allows for deeper submersion and a wider variety of birthing positions.

Your next steps…

1. Check out our new Prenatal Nutrition Class series. We ask all clients to take Prenatal Nutrition as early as possible to set yourself up for a healthy pregnancy. This class is free and offered virtually. Sign up here.

2. Request an appointment by filling out the form below. We do ask that you use this form to update personal and insurance information. Someone will be in touch to schedule you soon.

3. Reach out to us with any questions or concerns. You can call us at 913-735-4888.

Fill out this form to Request An Appointment:

Alumni Demographics 2023

Client Information

Emergency Contacts

Insurance

Preferred Pharmacy Location

Tell Us About You

Incredible Birth Days Start Here