Secure Submission Form

 

Virtual Prenatal Classes preferred date*

Virtual Prenatal Classes Second preferred date*

 

First Name *

Date Of Birth DD/MM/YY*

Street Address*

Province*

Email address

Healthcard Number

Your delivery physician or midwife

Expected delivery date

Last Name *

Daytime phone*

City*

Postal Code*

Confirm Email address

Birthing Coach

Where do you plan to deliver?

Preferred form of contact *

Payment options

The fee for the Virtual Prenatal Classes at Scarborough Health Network is $50.
We have several payment options. Please select the method that works best for you.
Your payment is required within one week of submitting the Prenatal Class Registration Form.
A member of the Birthing and Newborn Centre team will contact you once your payment has been processed to confirm your class booking.
Class enrollment will not be confirmed until your payment has been received.

In person

You may make a cash, credit or debit card, or cheque payment in person at the Cashier's Office at either of our hospital campuses:

  • Centenary - Located at the admitting area of The Court, open from Monday ‐ Friday,
    8 ‐ 4 p.m. (except on statutory holidays)

Over the phone using credit card

You may pay over the phone using your credit card. Please call our secure Credit Card Payment Line at 416-281-7248, and leave a message with the following information, your payment will be processed within 72hrs:

  • What the payment is for (i.e. Prenatal Class)?
  • Name of patient
  • Class date
  • Payment amount (the fee for the Virtual Prenatal Class is $50)
  • Card type (we accept Visa, MasterCard and American Express)
  • Name on credit card
  • Credit card number
  • Expiration date on card

Online using credit card (please fill in information below)


Payment amount (the fee for the Virtual Prenatal Class is $50.00 excluding taxes)

Name on credit card

Credit card number

Credit card expiration date

MM
YYYY
*Required fields

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