Perinatal Services Application for Mothers

To make an application to the Clinic for a Consultation, please complete the online form which can be accessed after agreeing with the Privacy Policy and Service Terms.

The information on the form will provide us with some preliminary information about what you are looking for and some details about yourself and how you see the difficulties and other matters that are bringing you to be thinking about this approach. Once The Winn Clinic has received and reviewed your form, you will be contacted by one of the Clinic staff.

Your personal information will be kept in accordance with the Winn Clinic's Privacy Policy. By submitting your completed application form, you agree to the Winn Clinic's Service Terms , including the handling of your personal information in accordance with the Winn Clinic Privacy Policy before you send any personal information to us.