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Birth & Postpartum Doula
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Postpartum Doula Needs
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Your Birth Plan Template
Postpartum Doula Needs
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Name
*
First
Last
Email
*
Phone
*
City
*
Share the city you reside
Estimated Due Date
*
What kind of support do you have from your family and friends?
Do you have other children? How many and what are their ages?
Birth Place
*
Hospital
Home birth
Birthing Center
Other or undecided
What are your current feeding plans for your baby?
Would you like our placenta encapsulation service?
Yes
No
Unsure and would like more info
How is your partner adjusting to the new addition (coming) to your family?
Do you have any spiritual or faith preferences in your family? Share what would be most helpful for your care.
Food & Diet Preferences
No preference
Have food allergies
Prefer a certain diet
Pricing-What payment options best suit your family's needs?
Able to afford the whole Postpartum package
Need a payment plan
Would like to discuss financial assistance or options
Are there any specific tasks or responsibilities you would like us to be aware of?
What are your biggest needs or concerns during your Postpartum period?
*
Comment or Message
*
Submit
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