All Information Is Confidential!
The following form must be filled out in order to receive Personal Email Support or Phone Support. Rather than fill this out for someone who does not have email access, please use our toll free number: 1-888-447-4754. Sidelines does offer international support by email only.
We do ask for sensitive and personal information such as ethnicity and medical background. Please be assured that all information collected is COMPLETELY CONFIDENTIAL. Our questions are designed to follow Center For Disease Control guidelines so that we are able to merge our confidential data with theirs. New data suggests that some medical conditions are more prevalent in certain age groups, races, and geographical locations. We are in the unique position to be able to provide the medical community with information which could improve the scope and effectiveness of prenatal care, diagnostic and treatment options.
As well as providing important medical data, the information you provide allows us to match you as closely as possible with a volunteer. Due to the high demand for online and phone support Sidelines can only offer personal support to those who are currently pregnant or in need of NICU support. We can match you with a trained Sidelines volunteer who has previously experienced a similar pregnancy complication. Depending on which you choose, your volunteer will support you throughout the remainder of your pregnancy and / or NICU experience through email messages or by calling you on the phone.
Please note: Sidelines does not give medical advice. If you want more specific information on your treatment plan, have questions about the medications you are taking, or think you might be in pre-term labor, please call your medical professional, case manager, or local hospital.
If you would prefer for someone to contact you by phone instead of filling out this form online, or you need immediate assistance, please call our toll free number (888) 447-4754 (HI-RISK4).
If you do not need personal support but are interested in getting other information about Sidelines, please go to our Sidelines Packets and Brochures Order Form.
Due to a problem with our email server, please fill out the form below then print screen and paste it into an email. Send the email directly to firstname.lastname@example.org
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