May 2026 Childbirth Class Registration Form

10 Topics Relaxation Breathing Techniques Medications Self Care Methods of Childbirth Baby Care Johnston County Public Health Childbirth Classes Class Dates Session 1 Wednesday , May 13 Session 2 Friday , May 15 Session 3 Wednesday , May 20 Session 4 Friday , May 22 Time 5 00pm - 7 00pm It is important to attend all classes Johnston County Public Health 517 North Brightleaf Blvd Smithfield , NC 27577 May 2026PageMethod of Payment Check one Medicaid Plan Name ID # Your Provider Doctors Office Doctor’s Office Phone # Must provide doctor’s NPI # Private Insurance Why take a Childbirth Class Registration Name Date of Birth Address Phone Your Baby’s Due Date Support Person Name Childbirth classes are recommended during the third trimester of pregnancy This class will help you and your partner prepare for the birth You will receive approximately 8 - 10 hours of class instruction This class is open to everyone If you have Medicaid , your doctor will need to fax a referral form If you are a non - Medicaid client or have private insurance , you will need to bring proof of household income to JCPHD JCPHD does not file private insurance Cashiers are open Monday - Friday 8AM - 5PM Childbirth class is taught by Kimetha Fulwood , Health Educator Call 919 - 989 - 5200 with questions Plan Name Policy ID # Bring proof of income for every working person in your home to JCPHD Cashiers Complete this form and bring it to the Johnston County Public Health Department Women’s Health Clinic or have your doctor fax the form to 833 - 438 - 7004 Self Pay Sliding Scale Bring proof of income for every working person in your home to JCPHD Cashiers Page