Free Consultation Form
Please allow 24-48 hours for processing and response.
For more acute needs please email connect@michellebeers.com.
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Email *
Primary Contact - *
Your First and Last Name
Secondary Contact - Skip if not applicable
First and Last Name of your primary support person; please specify relationship (spouse, partner, parent, friend, etc) 
Email address(es): *
If adding multiple email addresses, please specify to whom they belong.
About which services are you inquiring? *
Please check all that apply.
Required
For prenatal and labor and postpartum inquires, - when is your estimated due date?
If you are seeking postpartum care and have already given birth, please select your baby's birth date.
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For postpartum inquiries - please share when you need services.
Please include: estimated start date, number and age of babies, days of week, time of day, and an estimate of total hours needed per week. If you have not yet given birth please share your anticipated need.
For lactation inquiries - please check off all that apply.
If you have not yet given birth please select the option(s) closest to your anticipated goals. If you do not see your circumstance listed please specify in "Other".
For lactation inquiries - please check off all that apply.
 If you do not see your circumstance listed please specify in "Other".
Let me know any information not already shared that you would like to discuss during our consult!
A copy of your responses will be emailed to the address you provided.
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