

| 304 South Cottonwood Suite A Richardson, TX 75080 214-366-3579 loverslanebirthcenter@msn.com |
| Forms for our Clients Please print out and complete these forms before your first visit. Client Registration Medical History Nutrition in Pregnancy Diet Diary Consent for Care Home Birth and Birth Center Disclosure Form Privacy Disclosure Consent for Mana Statistics Thank you! |
| Site Design & Photographs by Earth Mama Photography |