earthside with erin BABY groups

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Email *

Full Name *

Phone Number *

City / Zip *

Baby's Birth (or Due) Date + Name *

Meeting Availability (Check All That Apply) - Groups Meet for 90min. Sessions Weekly *

Mondays 9a - 12p

Tuesdays 9a - 12p

Wednesdays 9a - 12p

Thursdays 9a - 12p

Fridays 9a - 12p

Mondays 12 - 3p

Tuesdays 12 - 3:30p

Wednesdays 12 - 2p

Thursdays 12 - 3:30p

Evening Only

Required

Choose the statement that characterizes your situation: *

I am/will be a stay-at-home mom

I'm on maternity leave + will be returning to work full-time

I'm on maternity leave + will be returning to work part-time

I'm already back to work

I work part/full time BUT have a very flexible schedule

I'm a SINGLE working mama

I'm undecided as to whether I will return to work and/or what my "work" situation will be

Other:

Choose the statement that best describes your breastfeeding choices/experience :

I hope/intend to breastfeed my baby

I am breastfeeding my baby + the experience has generally been positive

I am breastfeeding by baby but it's been challenging

I am trying to breastfeed my baby but need (additional) lactation support

I am exclusively pumping to give my baby breastmilk

I am breast AND formula feeding my baby

My baby exclusively drinks formula

My baby exclusively drinks donor breastmilk

Other:

Clear selection

Choose the statement that most accurately describes your baby's delivery:

I am still pregnant or otherwise expecting my child

I delivered my baby vaginally

I delivered my baby by planned cesarean

I delivered my baby by emergency/unplanned cesarean

I adopted my baby

My baby was delivered via surrogate

My wife/partner delivered our baby

Other:

Clear selection

Please share any specifics questions, concerns and/or topics you would like to discuss in baby group:

Anything else you would like to share about your pregnancy, childbirth and/or parenting experience?

Send me a copy of my responses.

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