Prenatal Education Classes REGISTRATION FORM - Mount Sinai Medical Center & MC Prenatal Classes VIRTUAL CLASSES - Confirmation Message will be emailed within 72 hours. Includes details about the class and the Link you will use to access class. IN-PERSON CLASSES - Confirmation Message will be emailed within 72 hours. Includes map and directions for the location of class. If you do not receive your Confirmation email, please contact us at: mtsinaichildbirthclass@mcdsonlinedoulas.com OR call us at 954.433.CARE (2273). Estimated Due Date (or) Induction Date (or) Cesarean Date:(Required) Month Day Year Your Name:(Required) First Last Person Attending Class With You: First Last Best Contact Phone #(Required)I consent to receiving text messages so the Class Instructor can communication with me:(Required) Yes No NO marketing material will be sent to you. Text is used only as a form of communication with the Class Instructor to provide important class related information.Preferred Email:(Required) This is the Email Address we will use to send you the formal Class Confirmation & the Link you will use to access your class. Alternate Email: Backup Email - Include this Address if you would like us to send your Partner the Class Link or as a BackupYour Full Address:(Required) Street Address City ZIP / Postal Code Your OB and/or Midwife's Name:(Required)Please include the Providers Full Name & Group/Practice NameBirth Location Name: (Hospital's Name, Birth Center Name or Home Birth)(Required) MOUNT SINAI & MC CLASS MENU & PAYMENT OPTIONS IN-PERSON CLASS LOCATION - Mount Sinai Medical Center, Miami Beach, FLCLICK HERE for Parking Fees at Mount Sinai (Class Fee does NOT include Parking Fee)VIRTUAL CLASSES: Online - Google Meet GROUP CLASSES: Classes you take with other expectant couples. ONLY AVAILABLE FOR: “1-Day Childbirth Preparation Class” and “Infant Feeding & Newborn Care Basics Combo Class”. No additional fees to attend group classes. Minimum of 4 couples for In-person Classes. If the minimum is not met, class converts to a Virtual Class. Contact MC for information about a group class: momsdoula@mcdsonlinedoulas.com PRIVATE CLASSES: Classes are for you and your partner only (grandparents are welcome). You must receive written approval BEFORE confirming a private class. Additional Fee of $200.00 per Class Offered virtually or in your home - Based on Instructors Availability. Contact MC for information about a private class: momsdoula@mcdsonlinedoulas.com PAYMENT OPTION 1 - Pay with a Debit or Credit Card (Visa, MasterCard or American Express Accepted)(PAYMENT OPTION 1) GROUP CLASS - SELECT CLASS TYPE VIRTUAL CLASS IN-PERSON CLASS (PAYMENT OPTION 1) GROUP CLASS - SELECT CLASS TOPIC & PRICE 1-Day Childbirth Preparation Class 3-Class Series: Prenatal Childbirth Preparation Class 5-Class Series: “Fear•Less”® Childbirth Class 3-Hour Infant Feeding & Newborn Care Basics Combo Class 3-Hour Introduction to Breastfeeding Class 3-Hour “Your Amazing Newborn!” Care Class 3-Hour Infant Feeding Choices: Pumping & Storing Breastmilk & Formula Safety 3-Hour Preparing for Cesarean Birth Private Class Additional Fee (PAYMENT OPTION 1) TOTAL AMOUNT DUE: (PAYMENT OPTION 1) CREDIT/DEBIT CARD PAYMENT FORM: Cardholder Name Card Details PAYING WITH CREDIT/DEBIT CARD: Payment Receipt will be sent to you separately. If you require an Invoice, please contact MC: momsdoula@mcdsonlinedoulas.com Title of the document