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Postnatal care
online service request

Last name: *
First name: *
Address:
City: *
Postal code:
Phone: *
Email: *

How many children:
How old are they: (Example : 3 months, newborn)
How many days per week?
1 to 2 days
3 to 4 days
5 to 7 days
What are the hours ?
(Example : from 08:00am till noon (minimum 4 hours)
 
Duration of postnatal care?
(Example : 1 month, 3 months)

* Please note that the information provided in your request online
is kept confidential in our secured website.
*Mandatory fields

 

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