Newborn Care Assessment

Newborn Care Assessment

Congratulations on your baby! Please take some time to answer the questions below regarding your new baby and how we can support you.
Name*

First NameLast Name
Spouse/Partner's Name*

First NameLast Name
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
How did you hear about us?*
What is your estimated due date?*
Is this your first child?*

YesNo, but we are looking for a different level of support this time.
Tell us a little about your pregnancy journey so far.*
What made you interested in concierge newborn care, and specifically the Natural Kid Doc approach?*
What are you most anxious, overwhelmed or uncertain about as you prepare for birth and the first year?*
What kind of support do you feel would help you feel calmer, more confident and better prepared as a new parent?*
When it comes to medical decisions for your baby, how would you describe your ideal relationship with your pediatric provider?*
Our concierge model is collaborative and discussion-based. How comfortable are you with shared decision-making, where we discuss options together and you choose what feels best for your baby and family?*

Very comfortable — this is exactly what I wantMostly comfortable but I have questionsI prefer the provider to tell me exactly what to doI prefer to do all my own research and make decisions independently
Do you value attending routine well-baby visits and proactive care in the first year?*

Yes, absolutelyUnsureNo
What does “a successful first year” look like for you and your baby?*
What would make you feel most supported by the end of the program?*
Are you open to learning new approaches, receiving guidance, and partnering together throughout your baby’s first year?*

YesMostlyNot sure
This is a high-touch, high-access concierge membership designed for parents who want extensive 1:1 support and are ready to invest in a premium level of care. Which statement best reflects you?*

I am ready for a high level of support and understand concierge care is an investment in our family’s well-being.I’m highly interested and just want to understand the full details before committing.I am very cost-conscious and unsure if concierge-level care is right for us.
Is there anything else you’d like to share about your family, birth preferences, or what you’re hoping concierge care might help you with?*
Thank you for taking the time to fill out this form. We will contact you shortly to help determine the next best steps for your family.
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Newborn Care Assessment

Thank you for taking the time to fill out this form. We will contact you shortly to help determine the next best steps for your family.