Through our contract for services, your birth doula provides emotional, physical, and informational support to you and your birth partner throughout pregnancy, labor, and birth. Our goal is to create a calm, supportive, and respectful environment where you feel safe, heard, and cared for at every stage of your journey.
Your doula supports informed decision-making by sharing evidence-based information and drawing on professional training, experience, and skills. Support may include reassurance, perspective, and comfort measures such as positioning, massage, relaxation techniques, and suggestions to encourage labor progress. As an independent professional, your doula works for you and your family, not for your medical provider or place of birth.
The questions in this intake form are asked solely to help us better support you during your birth experience. Some topics may feel personal or sensitive, and you are welcome to share only what you feel comfortable disclosing. All information is kept confidential and will only be referenced if relevant to your care. Your responses allow your doula to provide more personalized support and share appropriate evidence-based resources as needed.
You are welcome to skip any questions you are not ready to answer. You may also share additional details with your doula at a later time if something comes up.
Basic information to help us get started.
Information about the people supporting you during pregnancy, labor, and birth.
Details about your household and daily environment.
Information about your current pregnancy and medical care.
Where and with whom you plan to give birth.
Previous pregnancy and birth experiences that may inform this birth.
Your hopes, priorities, and vision for this birth.
How your support system may show up during labor.
Please answer only what you feel comfortable sharing.
Anything else you’d like us to know.