Birth Boot Camp 10 Week Series
10 Week Live Series
Mom's Name
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Mom's Occupation
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Dad's Name
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Dad's Occupation
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Address
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Mom's Email
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Dad's Email
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Mom's Phone Number
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Dad's Phone Number
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Mom's Age
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Estimated Due Date
MM
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DD
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YYYY
Number of Children
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Number of Medicated Births
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Number of Unmedicated Births
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Number of Cesareans
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Number of VBACs
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Where are you planning on having your baby?
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Who is your care provider?
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Are you planning on hiring a doula?
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How did you hear about Birth Boot Camp?
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How do you feel about taking Childbirth Classes?
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How does your partner feel about taking Childbirth Classes?
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What type of birth experience are you hoping for? (ex: unmedicated, medicated, waterbirth, homebirth, etc...Feel free to elaborate.)
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