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Los Alamos Medical Center Childbirth Class Sign-up Form

Childbirth Class Sign-up Form

First Name*

Last Name*

Street Address Line 1*

Street Address Line 2

City*

State*

Zipcode*

Phone Number*

Email

Is this your first baby?*

No Yes

What is your due date?*

Who is your OB/GYN Provider?*

Which class series are you planning to attend?*

Jan 8 - Feb 5, 2020 March 6 & 7, 2020 (Friday 6 - 8:30 PM & Saturday 9 AM - 4 PM) Apr 22 - May 20, 2020 Jun 24 - Jul 22, 2020 Aug 12 - Sep 9, 2020 Sep 30 - Oct 28, 2020

*All classes are Wednesday evenings, from 6 PM to 8:30 PM (except series 2, March 6 & 7)

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Los Alamos Medical Center

3917 West Road
Los Alamos, NM 87544

505-662-4201

It is the policy of Los Alamos Medical Center to admit and treat all residents without regard to race, color, national origin, sex, age or handicap.

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