Virtual Birth Consulting
Once submitted, we will reach out to you to secure the $150 payment and schedule your virtual consultation with Allie!
Name
*
First Name
Last Name
Estimated Due Date
*
-
Month
-
Day
Year
Date
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Zip Code
This helps us see what resources are accessible for you and your family
Medical Provider
This is not required if you have not chosen a provider yet
Birthing Location
If delivering at a hospital or birth center, please enter the name of the facility
What do you picture when you think of your birth? This can be anything that comes to mind!
Which type of birth are you planning for?
Unmedicated
Epidural
IV Pain Medication
Scheduled Cesarean
Unsure
Are you looking for evidence based information on any of the following topics?
Delayed Cord Clamping
Circumcision
Newborn Vaccines
Holistic Methods of Induction
Medical Methods of Induction
Placenta Encapsulation
Cesarean Birth
VBAC (Vaginal Birth After Cesarean)
Are you interested in receiving referrals for any of the following services?
Chiropractic Work (Pediatric and Prenatal)
Mental Health Support and Resources
Pelvic Floor Therapy
Lactation Support
Massage Therapy
Craniosacral Therapy
Birth Doulas
Postpartum Doulas
Indigenous Birth and Postpartum Support
Birth and Newborn Photography
IBCLCs / Pediatric Dentists (Lip/Tongue Tie assessments)
Submit
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