Make Space For Baby
Thank you for creating space to complete this form. Your feedback is precious to me as I write "Make Space For Baby: Your Preconception Guidebook for Preparing Heart, Home & Body". To gather information in support of your journey, the following form includes questions about your conception and pregnancy journey. Your responses are confidential unless you choose to add your phone number and email at the end in response to being contacted for an interview. Thank you again. So much love, Jocelyn XOXO @jocelyngordon1 |
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Pregnancy & Conception
Are you pregnant?
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Are you trying to conceive?
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I want to start trying to conceive
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If you are or have actively tried to conceive, have you experienced any delays in conception (beyond six months of consistent effort)
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If Yes, what were/are your next steps? Did you stop your efforts? Did you lean into acupuncture or other holistic methods? Did you invest in fertility treatments? Please share a bit of your fertility journey.
Conscious Conception
If you are trying to conceive, how long have you been trying?
Have you had a Conscious Conception journey?
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If yes, how did you prepare for conception and parenting
Please share more about your Conscious Conception Journey
Prior Pregnancies
Number of pregnancies continued past 4 1⁄2 months (20 weeks)
Number of miscarriages
Number of stillbirths
Number of abortions
Number of living children
What do you want to know
What you would like to know, learn, explore *
What else would you like to know and see in this book? Please be specific. *
Fears, Concerns & Desires
Which one describes you *
Please share any fears you may have *
Desires & Dreams
Describe your ideal conception, gestation and birthing vision *
What's Next
Anything else you would like to share or ask
May I contact you directly to interview you for the book? If yes, please include your NAME, PHONE # & EMAIL address:
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