Doula Support Registration Information
Please complete this form so that I can learn a little about you and how I can best support you.
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Your Full Name and Pronouns *
Your Birth Partner's Full Name and Pronouns (if applicable) *
Your Estimated Due Date *
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Which doula support package are you interested in? *
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Your Healthcare Provider's Name
Your Chosen Birthing Place- Hospital Name, Birth Center, or Home (If you haven't decided, feel free to write undecided)
Your Mailing Address *
Cell or Home Phone (please indicate which you are providing) *
Partner's Cell or Home Phone if Applicable(please indicate which you are providing) *
Your Email *
Partner's Email
Will this be your first time giving birth? *
If you have given birth before, please describe your experience.
What are your beliefs about birth in general?
What are your thoughts on your upcoming birth?   *
Bundle of Joy sends 3-4 email newsletters per year with interesting birth-y news, free support groups, coupons, and more.  Would you like to receive this newsletter? (You may unsubscribe at any time)
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Please confirm you understand and agree that Emily McMichael is not a medical provider and does not give medical advice.  As a doula, Emily provides physical, mental/emotional, and informational support. *
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How did you find me? *
If word of mouth, who can I thank?
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