Personal Information

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Home Address

Who is attending the class with you?

How did you hear about the Prenatal Education Classes?

* I understand that the class I am registering for is being offered by University of Chicago Medicine as part of broad health education public outreach to the community.

I understand that only those who register for the class, will be able to participate in the class.

* 

I understand that refunds will be given up to the day before the scheduled class date. 

I understand if I do not attend the scheduled class, I can make a request to attend another day at no additional cost.