Doula Support Inquiry Form

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Are you pregnant or embarking on your postpartum journey?

I would love to connect and determine what kind of support may be best for you at this time!

Please answer the questions below to the best of your ability.

Once your responses are recorded, I will reach out to setup a consultation call or in person meet up.

I look forward to hearing from you!

Taylor LoGrasso

Tulua Healing Arts

Email *

First and Last Name *

Phone Number

Current Address *

My estimated due date is:

YYYY

I am looking for: *

Birth doula

Birth & Family Advocate to help with planning and preparation only

Postpartum doula - night support

Postpartum doula - day support

Blessing way ceremony facilitator

Gift certificate for friends/family

Prenatal bodywork / body balancing

Postpartum bodywork / body balancing

Other:

I have given birth ____ times.

I have support from: *

My partner

My parent(s)

My siblings

My friends / coworkers

I am lacking any reliable support

Other:

Required

I am experiencing the following complications (if any):

I heard about your from: *

Google search

Referred by someone (please type their information in the "Other" line)

Cape Fear Area Doulas

Cape Fear Acupuncture

Instagram

Facebook

Other:

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