Postpartum Wellness Assistance Form

If you need help during your postpartum period and cost or financial hardship is a barrier to your participation in the Postpartum Wellness Group, please complete the form below to enroll in our series free of charge.

The Postpartum Wellness Group is a four-week series held on Monday afternoons from 12:30-2:00 p.m. All participants are required to attend all dates in scheduled series. If for some reason you cannot make a session, please give us notice of your absence. No drop-ins will be accepted for this group.

If this is an emergency, please call 9-1-1. If you need local resources to therapist and other professionals, please contact us.

Name *
Address *
Phone *
Expected Due Date or Baby's Birth Date
Expected Due Date or Baby's Birth Date
Select which series you would like to attend. Class series are weekly on Mondays from 12:30pm-2:00pm. Check calendar for dates.