Appointments 2 — Grit + Grace Doula

NEW CLIENT QUESTIONNAIRE

Please fill out the form to contact me and schedule a consultation.

I am so honored and excited that you’re taking control of your birth experience and are interested in working with a Doula. Before we connect, I ask that you please fill out the questionnaire here so I am able to best serve you. Once you submit, I’ll be in touch to set up your free 30 minute consultation for us to connect via phone, Facetime or in-person. I so look forward to getting to know you!

Want to get in touch with me right away? Feel free to email me direct at theGGdoula@gmail.com or call/text (714) 253-2915

xo Teesee

Name

First Name

Last Name

Phone

(###)

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Partner's Name (if applicable)

First Name

Last Name

Partner's Phone (if applicable)

(###)

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Are both partners on board with working with a Doula so far?

Yes

Kinda

What does your ideal birth look like?

Who would you like to attend your birth?

How many children do you have?

Have you worked with a Doula before?

Yes

What support are you most looking for from your Doula?

When is your due date?

YYYY

Are you planning to get an epidural?

What questions do you have for me?

You can outline here or save for our consultation discussion

Anything else you'd like to share about your pregnancy journey?

Feel free to share whatever you're comfortable with, or you can save for our consultation discussion.

NEW CLIENT QUESTIONNAIRE

schedule A consultation