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Doula Consultation Request
Hey there! If you would like to chat about my Doula services, please fill in this form and I'll get back to you asap to set up an in-person or virtual meeting. ~Jess Kuypers, Birth and Breastfeeding
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Name
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Your answer
Email Address
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Your answer
Phone Number
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Your answer
When is your Estimated Due Date?
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Where do you live (town/city)?
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Your answer
What type of support are you interested in?
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Birth Doula Support
Postpartum Doula Support
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How would you prefer to meet with me for this consultation?
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Virtual (Google Meet)
In-person (in your home)
What days/times would work best for you for a consultation? (Please check all that apply)
Weekday
Weekend
Daytime
Evening
How would you prefer to be contacted to set up your consultation date/time?
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