Southlake Pediatrics employee benefits through amma parenting

As part of your employee benefits you are able to take select classes through Amma Parenting at no upfront cost to you. Please fill out the form below with specific eligible class selections, dates and locations. We will then send you an email confirmation(s) for your classes. You must complete the form in full or we will be unable to process your request. If you have questions or are unsure of class dates and times please note that in the comments section below and we will give you a call.

Please note: If we are unable to verify your employment you will be responsible for the tuition(s) of your class(es). For questions about eligibility and your benefits, please contact your HR department.

If there is no “sign up” button next to the class, then that particular class is full. Please select another option.

You must view the Waiver here and agree in the below form.

Eligible employees can choose from the following classes in any format, online, in person or virtual:

complete this form to sign up for a class

"*" indicates required fields

First Name*

Baby’s birth location*

Last Name*

I have read the above waiver and agree.*

Due Date*

How did you hear about Amma?*

Email*

South Lake Employee Email*

Phone*

This field is hidden when viewing the form

Metropolitan Employee Number*

This field is hidden when viewing the form

Metropolitan Employee Number*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Class Selections (Class name, date, time).*

South Lake Pediatrics employee benefit

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