Parent Profile – Fig Tree Childbirth Services

About the profile

Please fill this out if you are interested in my services so I can get a little more information about who you are. Thanks!

Birthing parent’s name

Support person's name

Relationship to birthing parent

Birthing person’s email

Support person’s email (optional)

Address (optional)

Birthing parent’s phone number

Support person’s phone number (optional)

Birthing parent’s occupation (optional)

Support person’s occupation (optional)

Expected date of delivery

Birthing parent’s age

Where do you plan to give birth?

Who is your doctor or midwife?

Are you working with a doula?

Yes

How has your pregnancy been? Any complications?

Please let me know if there is anything else I should know about you

Which services are you interested in

Postpartum support

Placenta encapsulation

Breastfeeding support

Other

How do you plan to pay at the time of service? (optional)

Venmo

Cash

Check

How did you hear about me?