Doula of Dreams Client Pre Informational Assessment Question Title * 1. Name (Required.) Question Title * 2. Email Address (Required.) Question Title * 3. Phone Number (Required.) Question Title * 4. What is your preferred way of contact? By email By phone No preference Question Title * 5. What are 3 of your goals and aspirations for your birthing experience? (Required.) Most important Important Not as important Question Title * 6. Have you previously worked with a doula or received birthing support services? (Required.) Yes No Unsure Question Title * 7. What aspects of your previous birthing experience, if any, would you like to replicate or improve? (Required.) Question Title * 8. List 3 things that you think are/will prevent you from achieving the goals listed in the prior question. (Required.) 1. 2. 3. Question Title * 9. Please identify any strategies that you are doing now to move you closer to achieving your goals? (Required.) Question Title * 10. How do you rate your current support system that you have in place for your birthing journey? (Required.) Question Title * 11. What specific support are you seeking from a doula during your birthing journey? Question Title * 12. Please list any specific cultural or spiritual considerations important to you during this time? Question Title * 13. Are there any specific fears or concerns you have about the birthing process that you would like support with? Thank you ~ You NailEd It! (Done)