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Class Registration

Prenatal Registration Form

Thank you for your interest in our Patient Education Classes. Please complete the following information and click the Submit button. You will receive a Form Confirmation e-mail that will show the information that you sent, so please double-check the e-mail address you submit. If you made a mistake, you can correct it and re-send. You will receive a class confirmation notice from the UAMS Patient Education Department at a later time.

Important Notice!
Pre-registration for classes is REQUIRED. You may register online through this web site or by calling (501) 686-8084. Space is limited, so please register early. Last minute registrations will only be accepted if space permits. For this reason, online registrations cannot be made on the 3 days before a class date, and you will need to call (501) 686-8084 to check on space availability.






 

 

Name:
Address:
City:
State:
Zip:
Daytime Phone:
Evening Phone:
E-Mail Address:
Comments:
1.  When is your Due Date?

 
2.  Will you be adding more than one baby to your family with this delivery?  (Will this be a multiple birth?)
 Yes      No  (If no, please skip to Question 4.)
 
3.  If you answered "YES" to Question #2, please indicate the number of babies expected with this pregnancy:
 Twins (2)      Triplets (3)      Quadruplets (4)      Quintuplets (5)      Sextuplets (6)
 
4.  Will Another Person be Attending Class with You?
 Yes      No

You may wish to sign up for all of our Prenatal Classes, or only one. Select the box next to the class(es) you would like to register for, then from the drop-down menu, select the date you would like.

Breastfeeding:

Infant CPR & Safety (NEW for 2008!):

Labor & Delivery Unit Tours:

Newborn Care Class:

Preparing for Birth (A Labor & Delivery Unit Tour Included with this Class):

Relaxation During Labor & Delivery (NEW for 2008!):

Sibling Class (A Labor & Delivery Unit Tour is Included with Class):



This Web page can be used in addition to the information you get from your health care provider. Your health care provider should always be your first source of health information. Information from this Web page should not be seen as personal medical advice.

Department of Patient Education
University of Arkansas for Medical Sciences
4301 West Markham Street #526
Little Rock, AR 72205
Telephone (501) 686-8084    Pager (501) 688-6874