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Doula Consultation Request
Birth is a sacred and physiologically normal process. Inviting labor support in the form of a doula allows you to truly experience your optimal birth.
As a certified full spectrum doula, I will remain by your side bringing knowledge, support, and comfort as you experience labor and delivery.
Complete this form and I will contact you within 36 hours.
Which services interest you? - view full descriptions of services at
Virtual Doula ($55)
Standard Package ($1100)
Deluxe Package ($1300)
Elite Package ($2000)
Birth Partner's name and relationship, if applicable
Preferred Method(s) of Contact
Care Provider and Planned Birth Location
Estimated Due Date
Do you have any special needs or circumstances you would like me to be aware of?
Total number of pregnancies, including this one?
Is/was there anything remarkable about your pregnancy/ies that you would like to discuss?
How did you hear about Birth Boot Camp?
#1 preferred consultation date & time
#2 preferred consultation date & time
#3 preferred consultation date & time
Requested Consultation Location?
ALL CONSULTS ARE CURRENTLY BEING HELD VIRTUALLY
Pewter Spoon, 87 Albany Street Cazenovia
Starbucks, 217 West Genessee Street Fayetteville
Barnes & Noble Cafe, 454 Erie Blvd E DeWitt
Starbucks, 7567 Oswego Road Liverpool
Bloomin' Cup 13 Clinton St, Tully, NY 13159
Dunkin Donuts 369 North Peterboro Street Canastota
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