Make Space For Baby

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Make Space For Baby

Thank you for creating space to complete this form. Your feedback is precious to me as I write "Make Space For Baby: Your Preconception Guidebook for Preparing Heart, Home & Body". To gather information in support of your journey, the following form includes questions about your conception and pregnancy journey. Your responses are confidential unless you choose to add your phone number and email at the end in response to being contacted for an interview. Thank you again. So much love, Jocelyn XOXO @jocelyngordon1 | www.hoopyogini.com/links

Pregnancy & Conception

Are you pregnant?

Yes

Clear selection

Are you trying to conceive?

Yes

Not trying but not preventing

I'm already pregnant

Other:

Clear selection

I want to start trying to conceive

Right away

In three months

In six months

In one year

Within the next three years

I'm not sure

I want to have a baby however the world is a bit crazy right now and I am confused

I'm done having babies

Other:

Clear selection

If you are or have actively tried to conceive, have you experienced any delays in conception (beyond six months of consistent effort)

Yes

Haven't started trying so cannot say

Clear selection

If Yes, what were/are your next steps? Did you stop your efforts? Did you lean into acupuncture or other holistic methods? Did you invest in fertility treatments? Please share a bit of your fertility journey.

Conscious Conception

If you are trying to conceive, how long have you been trying?

Have you had a Conscious Conception journey?

Yes

Not Yet

I'm not sure of what that is

Other:

Clear selection

If yes, how did you prepare for conception and parenting

Please share more about your Conscious Conception Journey

Prior Pregnancies

Number of pregnancies continued past 4 1⁄2 months (20 weeks)

Number of miscarriages

Number of stillbirths

Number of abortions

Number of living children

What do you want to know

What you would like to know, learn, explore *

Stress Reduction

Fear Release

Feng Shui for Conception

Ancestral Healing

Healing After Abortion

Healing After Pregnancy & Birth Loss

Communication with Spirit Baby

Mother Issues & Addressing the Mother Wound

Father Issues

Preconception Detox

Addressing Conflicting Emotions - ex. I want a baby. I don't want a baby.

Physical Space & Physical Wellbeing (preconception detox and tending the sacred vessel)

Psychic Space & Mental Wellbeing (your thoughts and beliefs)

Relational Space & Wellbeing (audit of self, partner, family, business relationships)

Emotional Wellbeing (tending to your emotional world, unresolved issues, unaddressed trauma)

Sacred Space & Spiritual Wellbeing (your daily relationship with Spirit)

Financial Wellbeing (preparation for parenting)

Preconception Traditions Around The World

Self-Care Strategy

What else?

Required

What else would you like to know and see in this book? Please be specific. *

Fears, Concerns & Desires

Which one describes you *

I am super excited about parenting and I can't wait for my turn

I am a parent and I want to do things differently

I have conflicting emotions - ex. I want a baby. I don't want a baby.

I want to become a parent yet I am concerned about my fertility

I want to become a parent and I am un-partnered

I want to become a parent and I am not sure if I want to be partnered

I want to become a parent and I am not sure if my current partner is my ideal co-parent

I want to become a parent and I am concerned about the future of Earth and humanity

I want to become a parent and I want to parent differently than those who raised me

I want to become a parent and I am not sure if I want to give birth myself, have a surrogate or adopt

I've experienced abortion and I'm not sure if I deserve to have a baby

What else - speak your truth

Other:

Required

Please share any fears you may have *

Desires & Dreams

Describe your ideal conception, gestation and birthing vision *

What's Next

Anything else you would like to share or ask

May I contact you directly to interview you for the book? If yes, please include your NAME, PHONE # & EMAIL address:

Submit

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