MSMC Employee
Complimentary Class Registration Form

REGISTRATION FORM - MSMC Employee Complimentary Class

THIS FORM IS FOR MSMC EMPLOYEES ONLY
Were you Approved for a Complimentary Class? If not: REQUEST APPROVAL HERE
Approval grants you 1 (one) Prenatal Education Class of your choice.

I RECEIVED APPROVAL: Complete Registration Form Below

VIRTUAL CLASSES - Within 72 hours a Confirmation Message will be emailed to you and includes details about your class and the Link you will use to access your class.
IN-PERSON CLASSES - Within 72 hours a Confirmation Message will be emailed to you and includes a map and directions for the location of your class.

If you do not receive your Confirmation email, please contact us at: mtsinaichildbirthclass@mcdsonlinedoulas.com OR call us at 954.433.CARE (2273).

IMPORTANT - Your class registration is subject to confirmation that a class has other couples registered to attend. If no one registered to the class you are requesting to attend, you will be informed and offered the option to attend another class date that has confirmed registrants. Complimentary classes cannot be Private Classes attended just by you and your partner.

REGISTRATION FORM - MSMC Employee Complimentary Class
If you wish to register & pay for more classes, please complete our standard Class Registration Form HERE

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 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 Backup

Your 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 Name

Birth Location Name: (Hospital's Name, Birth Center Name or Home Birth)(Required)

MOUNT SINAI EMPLOYEE INFORMATION

COMPLIMENTARY CLASS TYPE & TOPIC: (Select Format of Class & Preferred Class Topic)

MSMC EMPLOYEES: This Registration Form is for 1 (one) Complimentary Prenatal Class.
If you wish to register & pay for more classes, please complete our standard Class Registration Form HERE

I AM AN EMPLOYEE OF MOUNT SINAI MEDICAL CENTER, MIAMI BEACH, FL.(Required)

Yes, I am a MSMC Employee

UPLOAD MSMC EMPLOYEE BADGE PICTURE(Required)

Accepted file types: jpg, gif, png, pdf, Max. file size: 512 MB.

Please Upload a Picture of your MSMC Employee Badge. This image will be used to identify you as a MSMC Employee and grant you 1 (one) Complimentary Prenatal Education Class of your choice.

COMPLIMENTARY GROUP CLASS - SELECT A CLASS TYPE(Required)

GROUP CLASS - 1 VIRTUAL CLASS

GROUP CLASS - 1 IN-PERSON CLASS

COMPLIMENTARY GROUP CLASS - SELECT 1 CLASS TOPIC(Required)

5-Hour Prenatal Childbirth Preparation Class

3-Class Series: Prenatal Childbirth Preparation Class

5-Class Series: “Fear•Less”® Childbirth 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

CLASS DATE YOU WILL ATTEND
CLICK HERE for CLASS CALENDAR

VIRTUAL CLASSES: ONLINE CLASS - Class Uses Google Meet

IN-PERSON CLASS LOCATION - CLICK HERE for Class Location & Map

If you are unsure of the date, contact us at: mtsinaichildbirthclass@mcdsonlinedoulas.com OR momsdoula@mcdsonlinedoulas.com

DATE OF CLASS YOU WILL ATTEND:(Required)

(Example: Childbirth Class - 01/01/0000 or January 1, 2024)

Title of the document

RECOMMENDED ITEMS TO HAVE FOR YOUR CLASS:
For Childbirth Class or Series, Breastfeeding Class and or "Your Amazing Newborn Class"

FOR VIRTUAL CLASSES - You will need a desktop computer/laptop with a camera & microphone. We do not recommend you use your phone or a small screened tablet. You might not be able to see the class presentation, images and/or video clearly. For those who desire to enhance their learning the following is a list of additional items you can purchase and use during your classes.

FOR IN-PERSON CLASSES - It is NOT mandatory but HIGHLY RECOMMENDED to have the following items. You can still participate if you do not have them. Having them, however, can be helpful during the interactive sections of the class that may include: learning comfort strategies and position changes for labor and birth, infant care techniques like how to hold, burp, swaddle and diaper change a newborn, and nursing/feeding positions, correct latching at the breast, paced bottle feeding and more!

Where to find these items: See our Amazon "Idea List for Classes" to find/purchase a birth ball, baby doll or other items
CHILDBIRTH CLASSES (5-hour Class or Class Series): A Birth Ball & Yoga Mat (Click Here for Birth Ball Sizing)
"INTRODUCTION TO BREASTFEEDING" CLASS: 20 - 22 Inch "Baby Doll", Nursing Pillow and or Regular Pillow
"YOUR AMAZING NEWBORN" CLASS: 20 - 22 Inch "Baby Doll"

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REFUND-CANCELLATION POLICY & TRANSFER OF SERVICES:

ALL CLASSES ARE NON-REFUNDABLE - There are No Exceptions. While classes are non-refundable the are transferrable. See below for details.

WHAT IF I MISS A CLASS OR A WHOLE CLASS SERIES? If you are unable to attend a class or class series you are registered to, you can request to be transfered into another class at a later time. You have 3 months (90 days) from the date of your paid registration to be transferred into another class. If this time expires, you must register again. You are responsible for the entire payment. No refund or discounts will be issued. To request a transfer to another class, please contact us as soon as possible, in writing by email.

TO CANCEL YOUR CLASS & REQUEST A TRANSFER INTO ANOTHER CLASS DATE: Email us at momsdoula@mcdsonlinedoulas.com.

ARE THERE ANY OCCASIONS WHERE THE CLASS MAY NEED TO BE CANCELLED/RESCHEDULED? There may be an occasion where, due to a circumstance beyond our control, the class may have to be rescheduled. In the event your class must be rescheduled we will contact you as soon as it is possible. You will be contacted and offered the choice to join the next scheduled class date. As our Refund-Cancellation Policy states, there are refunds. Instead, MC has 3 months (90 days) from the date of your paid registration to transfer you into another class but will make every attempt possible to reschedule you into the closest date available.

REFUND & CANCELLATION POLICY ACKNOWLEDGMENT:(Required)

I have read and agree to the Refund & Cancellation Policy

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WHAT HAPPENS AFTER I SUBMIT THIS FORM?

(1) An automatic Confirmation and Thank You message will appear on your screen signaling that your Form was received and will be reviewed by our MC Administrative Staff.

(2) A follow-up message will be generated and you will receive an emaill to the address you included on your form.

(3) The Official Confirmation Message that includes specific details about your classes including a confirmation of the dates, times and locataion will be emailed along with a separate & Google Invitation. The Official Confirmation & Google Invite will be sent to you within 72 hours.

If you wish to register & pay for more classes, please complete our standard Class Registration Form HERE

If you have any questions, please contact momsdoula@mcdsonlinedoulas.com or call us at 954.433.CARE (2273)

These forms are copyrighted and cannot be copied/used/reproduced without our authorization.

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I STILL HAVE QUESTIONS! - Please submit your questions here, OR email us at: mtsinaichildbirthclass@mcdsonlinedoulas.com OR contact us at 954.433.CARE (2273).

MSMC Employee Complimentary Class Registration Form

REGISTRATION FORM - MSMC Employee Complimentary Class

MOUNT SINAI EMPLOYEE INFORMATION

CLASS DATE YOU WILL ATTEND CLICK HERE for CLASS CALENDAR

RECOMMENDED ITEMS TO HAVE FOR YOUR CLASS: For Childbirth Class or Series, Breastfeeding Class and or "Your Amazing Newborn Class"

REFUND-CANCELLATION POLICY & TRANSFER OF SERVICES:

WHAT HAPPENS AFTER I SUBMIT THIS FORM?

MSMC Employee
Complimentary Class Registration Form

CLASS DATE YOU WILL ATTEND
CLICK HERE for CLASS CALENDAR

RECOMMENDED ITEMS TO HAVE FOR YOUR CLASS:
For Childbirth Class or Series, Breastfeeding Class and or "Your Amazing Newborn Class"