waterbirth provider online course 

HOSIPITAL REGISTRATION FORM

This form is specifically for hospitals who have contracted with Waterbirth International and Barbara Harper for online access to the Waterbirth Provider Certification Course. 

Only one representative needs to complete the form on behalf of the entire group. Please have the full names and email addresses of all participants ready.

Once you’ve submitted your form, each person will receive a confirmation email with instructions to access the course. Please be sure to check your spam or promotions folder if you don’t see the email right away.

If you have any questions or need assistance, please don’t hesitate to reach out to us at web@waterbirth.org. We are here to help.

Welcome to the Waterbirth International global learning community—we are so glad you’re here.

Please fill out the form below:

Hospital Prepaid Registration
YOUR NAME
YOUR NAME
First Name
Last Name/Family Name
Hospital/Facility Address
Hospital/Facility Address
City
State/Province
Zip/Postal
Country

Course Participants

Participant #1
Participant #1
First Name
Last Name
Participant #2
Participant #2
First Name
Last Name
Participant #3
Participant #3
First Name
Last Name
Participant #4
Participant #4
First Name
Last Name
Participant #5
Participant #5
First Name
Last Name

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