Schaefer Protocol Preconception Application
You found your way here for a reason. The Schaefer Protocol is designed for couples who are ready to stop guessing and start building their legacy together. Before we connect, I'd love to learn a little about where you are and what you're hoping for.
Her Name
*
First Name
Last Name
Her Email Address
*
example@example.com
Her Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
His Name
*
First Name
Last Name
His Email Address
*
example@example.com
His Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
How long have you been on this journey?
*
We're just starting out
Less than 6 months
Between 6-12 months
1-2 years
More than 2 years
Do you currently have any children?
*
No, this would be our first
She has children from a previous relationship
He has children from a previous relationship
We have children together
Both partners have children from previous relationships
Have you experienced any pregnancy losses?
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No losses
One loss
Two losses
Three or more losses
For any losses, at what week was the loss?
*
What other methods, support or resources have you tried? Select everything that applies.
*
IVF
IUI
Holistic or alternative treatments
Lifestyle changes (diet, exercise, supplements)
Therapy or emotional support
Acupuncture
Working with a fertility coach or specialist
None yet
Other
Are you aware of any factors that might be affecting your fertility?
*
Yes, we know there's a female factor
Yes, we know there's a male factor
Yes, there are factors for both of us
We suspect something but aren't sure
Not that we're aware of
What areas feel most challenging or uncertain right now? (Choose as many as resonate)
*
Not knowing where to start
Understanding our test results
Nutrition and lifestyle changes
Emotional toll / mental health
Relationship stress
Financial concerns
Navigating medical appointments
Feeling unheard by providers
This is a meaningful investment of time, energy and finance. Where are you with that right now?
*
Yes, we understand this is a financial commitment and I'm prepared
Yes, but we'd need to discuss the financial details first
Not currently, the timing isn't right financially
We understand both partners are required to be present for the discovery call
*
We will both be there
What would you most want me to know about your journey so far, and what does your dream outcome look like?
*
Share as much or little as you'd like - the discovery call is where we go deep, this just helps me show up prepared for both of you.
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