Birth Doula Support - client interest form
· If you are interested in moving forward in setting up your complimentary consultation, this confidential inquiry form gives me helpful intake information. Please fill out as much as you feel comfortable.
· If you simply have questions and are not looking to meet to discuss next steps yet:
a) Select "contact" via https://www.belleviebirthandbaby.ca/
b) OR directly e-mail belleviebirthandbaby@gmail.com
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Email *
Birthing person's full name and preferred pronouns: *
Where in Cape Breton do you live? *I am only able to provide in-person support to clients planning to deliver at the CBRH. *
What support package/bundle are you currently interested in?  *Please see website for details: https://www.belleviebirthandbaby.ca/birth-doula-support *
What is your estimated due date (EDD)? *In order to set up your consultation, I first need to know if I have availability during your due month. *
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Primary pregnancy care provider(s) (doctor/OB):
Do you have a partner/support person who plans to be at your birth?
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What made you consider hiring a birth doula or reach out? *
What birth number is this for you? Only share as much detail as you feel comfortable.
How would you prefer to meet for your initial consultation? *It is very important that we first meet to determine if we are a mutually good fit, so we can build a trusting, positive relationship leading up to your birth. This step is required before officially booking services. *
What is your usual availability/preference (including partner, if applicable) for our consultation? Select all that apply. *A specific date will be decided through direct communication.
How did you hear about my birth doula services and/or Belle Vie Birth & Baby? This helps me to understand how I'm best reaching clients. *
Do you have any other questions/comments you'd like to share?
Thank you for your interest in birth doula services!
I should be in touch by e-mail within 24 hours (weekdays) or 48 hours (weekends) to answer any questions and set up your consultation if I have availability during your due month. If you DO NOT hear from me after those timeframes, please reach out via the website contact option, or e-mail belleviebirthandbaby@gmail.com to ensure I received your inquiry form.
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