Midwifery Intake Request

For New and Repeat Clients: Please fill out both intake forms as our practice requires these two intake forms for your care request. 

For Clients in Care: please fill out the Alberta Midwifery Request for Care Form only. Please indicate in the notes that you are a current client and this is to complete your intake.  Thank you!

For Midwifery Intake inquiries ONLY please call Jordan directly at 403-619-3494

Please fill out the Alberta Midwifery Client Request for Care form and please make sure to choose Cochrane Community Midwives as your preferred practice.

Please fill out our intake form so we have all your details!