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Birth Photography Questionnaire
This questionnaire allows me to get a better idea of what to expect, should I get the opportunity capture your birth story
* Indicates required question
Name
*
Your answer
Phone
*
Your answer
Email
*
Your answer
Partner or Birth Support
Your answer
OB / Midwife
Your answer
Estimated Due Date
*
MM
/
DD
/
YYYY
People Attending
*
Partner
Doula
Midwife
Friend
Other:
Required
Birth Location Address
*
Your answer
Your Birth Plan
*
Basic Wishes on how you would like your birth to go
Your answer
When would you prefer for me to arrive to photograph your labor?
*
While I am laboring at home, before going to the hospital
When I arrive at the hospital
When I am in active labor
Other:
Services I am interested in
Memior of Motherhood - Maternity, Birth and Newborn Lifestyle
Birth Story - Active labor to 1-2 hours postartum
Golden Hour - 2 hours postpartum
Maternity Session
Newborn Lifestyle
Doula Services
Childbirth Education
Current Pregnancy
Normal, without complications
High Risk
Some minor complications, no concern as of now
Preterm labor / dialation
Other:
Clear selection
Past Labors and Delivery
Details of previous labors and deliveries (ei early, late, induction, labor duration, coping techniques used, any complications
Your answer
What birth aids do you plan on using?
Gravity assisted positions, breathing techniques, hypnotherapy , aromatherapy ect.
Your answer
Out of respect for your privacy, is there anything that you would like me to leave the room for? Or anything you would not like me to photography during labor and delivery?
Your answer
Are you aware if you are sensitive to noise, light or smells?
Your answer
Do you know your baby's gender?
It's a surprise!
It's a boy!
It's a girl!
Clear selection
Have you chosen a name for your baby? If so, what is the name you have chosen?
Your answer
Do you plan on breastfeeding or bottle feeding? Would you like pictures of you feeding your baby?
Breastfeeding. Yes, I would like pictures.
Bottlefeeding. Yes, I would like pictures.
No, I would not like pictures of me feeding my child.
Are there an details that are really important to you? I try to capture all the details that make up your story, this just gives me a better idea of things that are important to you.
Birth Support
Baby crowning
First look
Bonding with specific family members
Placenta
The cord
Other:
If you choose "Bonding with specific family members" please specify who.
Your answer
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