Your first step to great maternal care.


If you are pregnant and are interested in midwifery care, please complete our intake form. A WEM administrative staff will get back to you within a week to let you know if we have a midwife available for you due date.

Please complete the form below

Name *
Date of Birth *
Date of Birth
Midwives can care for anyone that lives in Ontario regardless of immigration or health insurance status. If you do not have Ontario health insurance (OHIP), don’t worry - a member of our intake team will call you within one week.
Phone Number *
Phone Number
Address *
Address Major Intersection
Partner Name *
Partner Name
Partner Phone Number *
Partner Phone Number
Emergency Contact Name
Emergency Contact Name
If different from partner.
Emergency Contact Phone Number
Emergency Contact Phone Number
If different from partner.
Estimated Due Date *
Estimated Due Date
If you need help calculating this, please visit the following link, then type in your result below.
If yes, explain
If yes, explain
If yes, explain
Have You Had A Baby With West End Midwives Before? *