Birth Questionnaire

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Birth Questionnaire

This is a vital piece to your story. This information helps me get to know you, your birth history (if any), and a heads up on your new little one making his/her debut. This information will be sent directly to me and not shared with anyone. Congrats again on your big day coming up! I can't wait to help you cherish it forever.

* Indicates required field

Your Name *

Email *

Cellphone Number *

Mailing Address *

Babys Gender? *

boy girl too early to tell going to be surprised!!

Babys first initial (or whole name if your sharing) ? *

My current pregnancy is... *

normal, no complications high risk some comlications, no current concerns

In your previous pregnancies you baby was... (check all that apply) *

this is my 1st delivery premature early right on time overdue induced C-section emergency c-section other

Excepted guess date *

This will be birth number *

How would you describe your other deliveries... *

first delivery beautiful emotional quick easy long painful peaceful scary other

If other please specify *

Care Provider *

Doctor Midwife Unassited

Care Providers Name *

Location your birth will take place *

What three words would you use to describe your ideal birthing atmosphere? (quiet, dark,, loud, fun, peaceful...) *

What I would FOR SURE like photographed * (check all that apply and you're welcome to voice something different during if you change your mind) *

labor/birthing waves breastfeeding baby weight/height footprints first bath care providers/nurses (with permission) family with baby Crowning shot (home birth only or with hospital permission, not shared publicly) placenta/cord real postpartum moments other

If other please specify *

How do you want your images documented *

real, honest, i want to see everything close crop, and able to show all images to family a variety of both

Is there anything specifically you DO NOT want photographed? *

This birth story will be something you cherish forever. What is most important to you that I capture? *

What do you want my role to be in your birth? *

photographer just hiding in the background photographer/doula combo helping me when needed doula first and foremost, capture random photos if I dont need support other

if other please specify *

What do you plan to do with your birth story photos? *

Keep on the computer for archiving share online with family/friends 'Reliving' my birth story in our custom-made album large art prints for walls other

If other please specify *

If for any reason there is an emergency during labor/delivery with you or baby, what would you like me to do? (I suggest keep documenting seeing that this time will never be recreated. Even if tragic, you deserve to remember.) I will respect whatever you choose momma. *

stop photographing and leave quietly respectively keep documenting check with me at the moment other

Additional comments, concerns, questions, thoughts? If not, we'll chat soon! Can't wait! *

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Location:Concordia KS

Photography that documents the real, raw BEAUTY, and BIZARRE parts of motherhood.

i am inspired by giggles, random acts of randomness, raw beauty, birth, babies, and friendships.

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Email *

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