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Aimee Broome, owner of Hypnobirthing with Aimee

Registration Form

Welcome to your Hypnobirthing with Aimee course. Please complete the following form in as much detail as possible and at least 48 hours before your course is due to start. That way I can ensure the course is tailored specifically to you, your pregnancy and where you are hoping to give birth.

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Thank you for this information.

Thank you for this information.

I am super excited to start this journey together and cannot wait to work with you towards having a calm, confident and empowering birth.

Please use this space to add any other information you feel is relevant before you start your Hypnobirthing course. 

If other, how would you describe it?

Tickboxes

What are you hoping to get from this course? Tick as many that apply. *

Where are you hoping to give birth to your baby? *

If other, how would you describe it?

Tickboxes

In an ideal scenario, how would you choose to give birth to your baby? Tick as many that apply. *

Can you briefly describe your current perceptions or feelings towards birth? *

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Current feelings towards labour and birth

Please try to answer this section as honestly as possible so that I can tailor the course to suit your needs.

Please add any relevant details of any special circumstances you have experienced so far in your pregnancy. 

How would you best describe your pregnancy to date? *

What is your estimated due date? *

How many weeks pregnant are you? *

Date you are due to start your course *

Email address of Mother & birth partner/s *

Names of Mother and birth partner/s *

* Indicates required question

The legal bit...

All information will be stored in confidence following the Data Protection Act 2018 and your details will not be passed on to any third parties or outside agencies. 

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