Expectant Parents
Great news, did we just meet! If so text me you filled this out the same day and get $10. off your booking!
Great news did you get referred by a Midwife, Doula, Dr. or one of my friends! Text me and get $25.00 off each session! Please feel free to visit our website at www.withpodwilltravel.net or IG @withpodwilltravel All answered are confidential and secure and will not be shared with anyone else. Solely to help me be prepared for our great conversation or to continue one we left off at!
Email address *
Name and City and State. like Tanya Ndip Bronx, NY *
Your answer
Mobile *
Your answer
Were you referred by a Midwife, OBGYN Dr or a Doula? If so please name the person you get a $25.00 discount per session. *
Your answer
Emergency Contact. Name and number. If you are not feeling well during the session and need someone to meet with you. *
Your answer
Check all apply to your needs. Sessions are not restricted to just clients. The family are welcomed. *
Required
Studio Time is $150 for 1 hour. Below are other rates Check any that you are interested *
Required
When your due date? *
MM
/
DD
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YYYY
Do you know how many babies you are carrying? *
Choose payment plan check all that apply *
Required
The next set of questions apply to those on public assistance or living in a shelter. Please Hit NA if that doesn't apply. If so continue to learn how your sessions are lowered to meet your needs. *
Do you have other children? *
Are you interested in earning an income as a representative for With Pod Will Travel? For every one person booked you get $25.00 Must be on public assistance or living in a shelter. *
Thank you for filling out this form. Please add any questions below. We will make sure to contact you back within 72 hours. If you need a session before the 72 hours or your due date is now or will be the week of November 17-25, we will reach you sooner. Please text us on 347-450-1850. *
Your answer
A copy of your responses will be emailed to the address you provided.
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