Thank you for your interest in Westside Midwives! PLEASE TAKE A MOMENT TO CAREFULLY READ THROUGH SOME IMPORTANT INFORMATION BEFORE FILLING OUT THIS FORM! Westside Midwives is located near Jericho Beach on the far West side of Vancouver. Due to the volume of people requesting care, we prioritize people who live on the West side of Vancouver and downtown. We are a full spectrum Midwifery care provider, we do not offer Post-partum only care. We are currently FULLY BOOKED for all JAN - OCT 2026 due dates. If you are expecting in these months, please DO NOT fill out this form, instead go to www.westsidemidwives.com/wait-list to be added to our wait list. PRIVACY: your privacy is our priority. We are committed to protecting the confidentiality, integrity, and security of your personal health information (“PHI”). Information collected here is in accordance with applicable privacy laws in Canada (PIPEDA) and BC (PIPA). We will not use your information for marketing or non-care purposes without your explicit consent. We maintain strict safeguards to protect your information from loss, theft, or unauthorized access.