Let's Talk About You:
Tell me about your birth / (Upcoming or Past births)
Name of Practice:
Phone Number of Practice:
People in Attendance:
List any people that will be attending the birth of your baby. Check any that apply.
Others, please explain:
How is it progressing?
Normal with no complications
Some complications, but no concern as of now
If this is not your first labor, can you please describe how you past labor/deliveries have gone? Check any that apply.
Within 1 week of EDD
1+ week past EDD
Within a few days of EDD
This is my first labor
Please give me a short synopsis of your past labor experience:
Do you know the gender of your baby?
No, we haven't found out yet
No, we are waiting until the baby is born to find out
If for any reason you are to be transferred from home to hospital or from one hospital to another for any reason, would you want me to:
Wait for Instruction
LET'S TALK ABOUT PICTURES DURING YOUR LABOR & DELIVERY
What I would like photographed:
check any that apply
Family in attendance
Care Providers - with permission
Nudity not ok
Side shot during delivery
Over the shoulder during delivery
Family with baby
Images with care provider and/or nurses
Other - please explain:
AS YOU PROBABLY KNOW, SOCIAL MEDIA IS MY LARGEST TOOL FOR SHARING MY WORK. I WOULD LOVE THE OPPORTUNITY TO SHARE YOUR (NON-REVEALING) BIRTH IMAGES IN MY PORTFOLIO AND WITH MY FOLLOWERS. BUT, ULTIMATELY, THE DECISION IS UP TO YOU.
Would you like me to post a birth announcement and/or birth story blog post about your birth experience?
A birth announcement would be posted on Facebook within 48 hours of your birth experience. A blog post would likely be published within a few weeks.
Yes, we would love that!
We would like to be the first to announce our news on social media, but you can post an announcement and blog post after we share our news.
No, thank you. We don't plan to share much over the internet.
Are you comfortable with me posting non-identifying social media updates about your labor & delivery experience? *
It's okay as long as you are very subtle
Please don't post anything
Any Additional Comments/Information?