To register for the self-guided online prenatal class, please complete the form below. When the form is submitted, you will receive an email with a link to the online prenatal class and an access code. Each person using the online prenatal class is required to register individually.
Please note all fields are
REQUIRED.
Last Name
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First Name
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Birth Date
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YYYY/MM/DD , for example (1980/01/21)
I am
Pregnant
Support Person
Due Date
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City
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Postal Code
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Email Address
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Confirm Email Address
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How I found out about the online prenatal class
Choose one
Community Program
Dr. Office
Event
Friend/Family
Healthy Babies Healthy Children
Health Connection (Phone Line)
Hospital
Midwife
Newspaper
Poster
Social Media
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By registering for this class, you provide the Simcoe Muskoka District Health Unit permission to send you a confirmation email and reminder emails about the online prenatal class through this system. The personal information on this form is collected under the authority of the Health Protection and Promotion Act, 1990 s.5. The information will be used for the purposes of program planning and service delivery. Documents are maintained pursuant to the Municipal Freedom of Information and Protection of Privacy Act, 1991 and the Personal Health Information Protection Act, 2004. Questions regarding the collection, use and disclosure of personal information should be directed to the Office of the Privacy Officer, Simcoe Muskoka District Health Unit, 15 Sperling Drive, Barrie ON L4M 6K9, (705) 721-7520 or 1-877-721-7520. All rights reserved. The user agrees not to infringe the copyright and will not, in whole or part, reproduce, store in a retrieval system, transmit, or sell any component of the online prenatal class.
I have read and agree to the above disclaimer.
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