Birth Client Questionnaire

Estimated Due Date
Estimated Due Date
Name *
Partner's Name
Partner's Name
Birth Location
How is your pregnancy progressing?
Previous labors: if this is not your first child, how did your past labor/deliveries go? (Please select all that apply)
What would you like photographed (Please select all that apply)
If a medical emergency should happen during birth, what would you like me to do?
Social media - would you like me to post a birth announcement and/or birth story blog about your birth experience?
Can I tag you in images on social media?
What do you intend to do with your birth story photographs? (Please select all that apply)