Welcome to Parent Vortex
Congratulations on stepping into this new season of parenthood! Whether you’re preparing for birth or already navigating life with your baby, you don’t need to have it all figured out — that’s why I’m here.This form is simply a way for me to get to know you, your family, and the kind of support that would feel most helpful. There are no “right answers” and you’re welcome to share as much or as little as feels comfortable. Fill out what feels relevant, and know that you’re already doing an amazing job by reaching out for support.
Back
Next
Parent Information
Pronouns
Full Name
*
Email
*
Address or Intersection & Zip Code
*
Phone number
*
Preferred Contact Method
*
Phone Call
Text
Email
Back
Next
Family Details
Baby's Name (optional) & Date of Birth OR Due Date
*
Partner's Name (If applicable)
Other Children at Home (names & ages)
Are you currently:
*
Preparing for birth / expecting
Postpartum / recently delivered
Back
Next
Type of Support Needed
What type of support are you interested in?
*
Postpartum Doula Support
Lactation Support
Both
Back
Next
Postpartum Doula Support
Which areas of support feel most important to you right now?
*
Emotional Support
Newborn Care
Household Help
Partner & Sibling Adjustment
Rest & Recovery
What days/times are you looking for support?
*
Preferred type of support
*
In-home
Virtual
Both
Any allergies, sensitivities, or household considerations I should know about?
*
Back
Next
Lactation Support
What does feeding look like for you right now?
*
Pregnant, want to prepare
Postpartum, breastfeeding/chestfeeding
Postpartum, pumping
Postpartum, bottle feeding
Combo feeding
Do you have specific concerns?
Latch
Milk supply
Pumping
Bottle feeding
Night feeding
Returning to work
Preferred support type:
*
In-home
Virtual
Both
Back
Next
Doula + Lactation Support
How is feeding going right now (or what are your questions before baby arrives)
*
Which areas of doula support feel most helpful to you?
*
Emotional support
Rest & Recovery
Household Help
Partner & Sibling Adjustment
Newborn Care
Do you have feeding-specific concerns?
Latch
Supply
Pumping
Bottle feeding
Night Feeding
Returning to work
Preferred type of support:
*
In-home
Virtual
Both
Scheduling preferences (days/times) What days/times are you looking for support?
*
Any allergies, sensitivities, or household considerations I should know about?
*
Back
Next
Final Notes
Is there anything else you'd like me to know before our first meeting?
Submit
Should be Empty: