If you are having an issue completing this application, please contact our office at 519-645-0316

Please tell us about yourself

Prenatal Screening is optional for all women and not a consideration in your application. Please note the time-sensitivity of this testing. Should you remain on our waitlist, please contact your health provider for more information. Prenatal Screening Ontario
Information in relation to your application:

The Ministry of Health and Long-Term Care – which provides funding for the Ontario Midwifery Program – would like to obtain information on the demand for midwifery services around the province.

To help the Ministry get the information it needs, we have agreed to ask individuals, we are not able to accept into care; due to limited services at our practice group, whether they would be willing to provide some basic personal information and consent to the disclosure of this information that will be collected through the Better Outcomes Registry and Network (BORN), a registry that collects information related to maternal, infant and child health.

BORN will provide de-identified information to the Ministry, in order to properly conduct a study that will assist in future planning for midwifery services across the province. This information is important in understanding the growing need for midwifery services and the need to fund more midwives.

You should know that:
▪ the Ministry will not receive your personal information and will only receive de-identified data;
▪ BORN will receive your personal information, only if you consent to this disclosure;
▪ you are under no obligation to provide this information, and if you do not consent, this will have no effect on your eligibility to receive midwifery care in the future; and
▪ BORN, on behalf of the Ministry is collecting this information solely for the purpose of conducting a study to assess the demand for midwifery services in the province, and will use it for no other purpose.

Please indicate your consent to provide your name, birth date, postal code, and expected date of delivery to the Better Outcome Registry Network (BORN)

If you have any questions or concerns about us collecting or disclosing this information, please contact our office at 519-645-0316 ext 222 or [email protected]