Complete this form to request a place on our next early days postnatal class Postnatal Class Booking RequestPlease enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.About YouName *FirstLastAddress *Address Line 1Address Line 2CityState / Province / RegionPostal CodeEmail *Phone *Date of BirthMarital Status *Select oneSingleIn a relationshipMarriedDivorced / SeparatedEmployment *Select oneWork full timeWork part timeStudyingNot workingLiving Arrangements *Select oneLive aloneLive with boyfriend / partnerLive with husbandLive with parentsOtherHow did you hear about us? *GP / Health clinicFriend / RelativeChurch / PastorSocial mediaInternet searchSocial servicesYouth eventOtherAbout Your PregnancyIs this your first child? *YesNoDid you have more than one baby? *NoTwinsTripletsQuadrupletsBaby's date of birth *Service Agreement *I have read, understand and agree with the information set out in the Limitation of Services listed below and request support from Stanton Healthcare East of ScotlandStanton Healthcare East of Scotland (also known as SHE Pregnancy Support) is a registered Scottish charity and is a pregnancy support service. We welcome anyone in an unexpected pregnancy situation and women who need general pregnancy support. Our services are provided free of charge. We offer pregnancy tests, information, education, befriending and practical help through our antennal and postnatal classes.Our services are not intended to be a substitute for NHS or pre-natal care or professional counselling. The information we offer is for general education and support only. For medical questions please seek advice from your GP or, in an emergency, dial 999. Stanton Healthcare does not provide either continuing or emergency medical care. You recognise that if you have any signs of bleeding, pain, or other pregnancy related health problems, you will seek further care at your GP or, in an emergency, dial 999. Stanton Healthcare will hold in the strict confidence all the information that the client provides, except under the following circumstances:When there is reasonable suspicion of child abuse, whether the client is the victim of the abuser;When there is reasonable suspicion of elder or dependent adult abuse;When there is a threat of harm to a third party;When there is a threat of self-inflicted harm;When there is a threat against the centre itself. To the extent required by law, we will make a report to the proper authorities in the instance of suspected abuse or threat or harm.GDPR Agreement *I consent to Stanton Healthcare East of Scotland holding and processing my data for the purposes of dealing with this formSubmit
