Childbirth Class Registration Information
Items with an (*) are required to process your request.
(Expectant) Mother's Name*:
(Expectant) Father's Name:
Address:
Phone*:
Scott & White Health
Plan Number (if applicable):
Email:
Due Date*:
Physician*:
Class Preference
Evening classes meet from 7 - 9 p.m. for four weeks.
Please select first and second choice
First Choice*:
Second Choice*:
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Scott & White • 2401 S. 31st St. • Temple, TX  76508
• 254-724-2111 • 800-792-3710 • 254-724-3038 (TTY)
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