BIRTH CLIENT QUESTIONNAIRE  

Client Information
Mother's Name *
Mother's Name
Partner's Name
Partner's Name
Date *
Date
Address *
Address
Emergency Contact *
Emergency Contact
Birth Information
Estimated Due Date *
Estimated Due Date
Birth Location
Birth Location Address *
Birth Location Address
Is this your first baby?
Labor Method
Have you spoken to your doctor about having a photographer at your birth?
In the event of a C-section, have you spoken to your doctor about allowing photography in the OR?
It is your right to include me in on your experience, YOU need to tell your birth staff if you want me in the OR.
Want to build a package? What additional services are you most interested in?
Birth clients receive additional services for a discount when bundled and bought as a package.
Will you have a doula or other support team present?