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Home Birth Midwifery Service

We Bring the Birth Center to YOU!!

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Share Your Birth Story !

We would love to use it on our website,
on Kim's Blog  and in the media!

  
Include your contact information below and write your story into the "message" space.
Kim will contact you if she has any questions.


Legal Release & Authorization to Use Your Material(s):

By submitting your written birth story via the form below -or- via a personal email to Kim, you are giving permission & authorization for Kim Lane, CPM to use and re-use your story (and any/all photos you provide), in part or in their entirety, for the purposes of marketing her HBMS practice in the way of a client's personal testimonial. Kim Lane will submit to you any proposed use of your material and/or photos for your approval prior to publication.

By clicking "Submit" below, you agree to this Release & Authorization in perpetuity.