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Doula Services

Welcome to a space where your journey through pregnancy, birth, and postpartum is met with compassion, expertise, and unwavering support. As a certified doula, Christine is here to empower you, celebrate your unique story, and provide the care and encouragement you deserve. Whether you’re seeking guidance, comfort, or advocacy, this is your place to feel seen, heard, and supported every step of the way.

 

Let’s walk this beautiful journey together. You’re not alone.

Personal Information

Thank you for choosing Christine as your doula! This form is designed to help us understand your needs, preferences, and expectations as we work together to support you during this transformative time. By completing this form, you provide essential information that helps us create a personalized and meaningful experience for your pregnancy, labor, and postpartum journey.

Birthday

Why a Doula

Payment Information

Do you have Medicaid?
If "Yes", what type of Medicaid do you have?

If “Yes”, Medicaid covers up to 12: prenatal and postpartum. Please indicate how you would prefer those 12 appointments be divided?

If “No” Medicaid what will be your payment method?

Multi choice (select all that apply)
Where do you feel you would benefit from the most support?
Prenatal Care
Labor & Delivery
Postpartum Care

Labor & Delivery Preferences

When would you like labor & delivery support to begin?
I want Christine with me as much as possible.
I would like Christine with me once I arrive at the hospital.
I want Christine to be with me once I begin active labor.
I would like Christine to be with me only after the baby gas arrived.
Other
What forms of comfort measures are you interested in during labor? (Selected all that apply)

Additional Support

Would you like lactation support?
Yes
No
Unsure

Agreement

By electronically signing this contract, I acknowledge and agree to the following:

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