Napa MomSquad Intake Form
Napa MomSquad offers support for pregnant/expectant and new families in Napa County via our weekly Meetups at Las Flores Community every Friday at 10am (currently being held via Zoom due to COVID). These weekly meetings are hosted by our volunteer team and open to the public. We embrace all families and welcome you to join us during your pregnancy/time of expectancy and with your babe in arms.
This form is a way for you to let our team know you are expecting another baby to join your family or have a baby under six months old*. If you indicate that you are interested in a mom mentor or further support, a MomSquad volunteer will contact you with further details within 5 days.
Napa MomSquad Valley is a program of Napa Moms, a member-led organization that strives to provide a supportive community for families to share meaningful experiences, resources, and friendships. An annual membership to Napa Moms costs $35 or is accessible via the Holly Bloom Memorial Scholarship. Learn more or sign up at
Please do not hesitate to contact us at
or call/text (707) 492-5794 with any questions. After completing this form, please subscribe to our website at
and join us on Facebook: @napamomsquad for updates on how our programs can support you.
All personal questions on this form are completely optional. Please feel no obligation to answer where you would not like to, simply leave the question blank. Thank you!
*This is a general guideline for who is most likely to use this form.
**Trigger warning, this form asks about past birth trauma
Facebook Profile Name
How did you hear about Napa MomSquad?
QVMC Community Outreach (Feeding your baby with love group, parenting classes, Synergy Medical Center)
Queen of the Valley OB
St. Helena Hospital OB
Community Agency (COPE, Mentis, Aldea, Community Resources for Children, Las Flores Community Center)
Are you already a member of Napa Moms Private Membership Group on Facebook?
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