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Hi there, please answer a few questions, and I'll be in touch soon!
11
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1
Name
First Name
Last Name
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2
Email
example@example.com
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3
Phone Number
Please enter a valid phone number.
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4
Preferred Communication Method
Text
Email
Phone Call
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5
Type of Support You're Seeking
Post-Partum Doula
Real Estate
Custom Hats & Patches
Other
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6
Is this your first baby?
YES
NO
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7
Age & names of other children in the home
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8
When are you due?
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Date
Year
Month
Day
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9
How many hours per day of support are you seeking, and are you looking for days or nights??
2 hours
4 hours
6 or more
Daytime
Nighttime
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10
What part of town are you in?
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11
Tell me a little bit about your needs, and we'll discuss the details further at our introductory meeting
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