Midwives of East Erie

Norfolk General Hospital Labour and Delivery reopened in 2022.
Midwives of East Erie has resumed low risk deliveries at NGH.

WE ARE COMMITTED TO YOUR INFORMED AUTONOMY

Experience expert pregnancy, birth, and postnatal care. Established in 2004, Midwives of East Erie was the first to proudly serve Haldimand and Norfolk Counties in Ontario. With three conveniently located offices in Dunnville, Cayuga, and Simcoe, we are committed to providing professional pre and postnatal care, empowering birth experience, and a safe health care environment to all our pregnant people and families.

CALL US TODAY!

Affiliated with McMaster University, Midwifery Education Program, Department of Family Medicine, as a teaching practice.

Thank you for growing with us!

Midwifery care is free in Ontario and all inclusive.

Fill out the Intake Form (you can self-refer) or call us with any questions at (905) 701-7428.

Intake Form

* Indicates required field

Your Name as it appears on your Health Card *

First

Last

Your Preferred Name (if different than on Health Card) *

First

Last

Your Occupation *

Your Partner's Name *

First

Last

Your Partner's Occupation *

Health Card Number with the two letter code at the end *

Name of Family Doctor *

Location of Family Doctor *

Date of Birth (please type name of month) *

Age *

Phone *

Email *

First Day of your last month's period *

Have you had any prenatal care in this pregnancy? *

Yes No

If yes, by whom? *

Do you have any medical conditions? (including diabetes, heart disease, epilepsy, high blood pressure, kidney disease or thyroid conditions) *

Yes No

If yes, specify: *

If you know your blood type, what is it? *

Address *

Line 1

Line 2

City

State

Postal Code

Country

Pre-pregnancy Weight *

Height *

Number of Times you have been pregnant (including this pregnancy) *

How many babies have you had? *

Are you a first time client? *

Yes Yes but have had midwifery care elsewhere No, I am a repeat client

Do you have any drug allergies or sensitivities? *

Yes No

If yes, specify: *

Any Problems with a previous pregnancy or birth: *

Where would you like to deliver your baby? *

If applicable, who referred you to our practice? *

Comments or Questions: *

Submit

If you don't hear back from us within one week of submitting an intake, please reach out!

We would like to recommend two things as part of your prenatal health:
1. Folate (400 micrograms) This is the natural form of folic acid. It may or may not be in the prenatal vitamin that you are taking. This is often available at health food stores, or health food sections of grocery stores.
2. Probiotics (see your pharmacist for recommended products).

Pregnancy. Birth. Family.

Intake Form

Office: (905) 701-7428
Fax: (905) 701-4400
[email protected]

​Pregnancy. Birth. Family.​

Intake Form

Office: (905) 701-7428​Fax: (905) 701-4400​[email protected]

Pregnancy. Birth. Family.

Office: (905) 701-7428
Fax: (905) 701-4400
[email protected]