Lactation Support + Education Intake
This google form will be used by Shannon Sweeney-Faber, CLE (BADT) of The Lovely Doula to acquire initial intake information before our services consult. Please note that these questions range from basic information to more personal and/or sensitive questions of which the answers to may be relevant to our relationship and your care. You are under NO obligation to answer any question that is uncomfortable for you. By completing this form, you are indicating you would like to book a paid session with me for either prenatal lactation education or postnatal lactation support. Please be aware that this form does mention lactation support service options for parents who are lactating but may not have a baby in arms or home with them.
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Email *
What is your name? (first + last, please!)  *
What are your pronouns?
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Where are you located?
What type of lactation service are you seeking? *
What is a good cell # to have on file for you? *
What is your age? *
Do you have a partner, spouse, significant other or life partner who will be present and supporting you through your postpartum and lactation/infant feeding journey?
 *
If you answered yes to the above question, what is their name? *
Tell me about your pregnancy and birth experience -  
When was your due date?
When was baby born? How did the birth go?
If you feel comfortable sharing, what type of birth was it (vaginal or cesarean) 

having this additional information can be important regarding the experience of postpartum :)
 *
Tell me a little bit about what is going on in regard to your current infant feeding experience and goals. *
How did you find me?
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Is there anything else you'd like me to know?
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