• The Envisioned Doula

  • Postpartum & Overnight Care Assessment

  • Congratulations on your growing family! ♥️ This assessment helps us understand your postpartum needs, newborn-care preferences, schedule, and support goals. Your responses help Brianna prepare for your consultation and determine which member of our care team may be the best fit for your family.

  • 1. About Your Family

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  • Preferred Method of Communication **

  • 2. Your New Addition

  • Estimated Due Date*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Is your delivery currently scheduled?
  • If yes, scheduled delivery / induction date?
     - -
    2 digit month, 2 digit day, 4 digit year
  • Is this your first baby?*

  • 3. Your Postpartum Support

  • Approximately how long are you considering postpartum support?
  • Approximately how many nights per week would you like support?*
  • Which nights would you ideally like coverage?*
  • Preferred overnight shift

  • How flexible are you regarding dates and scheduling?

  • 4. Overnight Care Goals

  • What would you like support with during overnight care?*

  • 5. Feeding Goals

  • What are your current feeding plans/goals?*
  • During overnight care, would you like baby brought to you for nursing?
  • Would you like support maintaining an overnight pumping schedule?
  • Have you previously breastfed or pumped?
  • Are you currently working with, or planning to work with, an IBCLC / lactation consultant?

  • 6. Newborn Sleep

  • What are your goals surrounding newborn sleep?

  • Care philosophy: The Envisioned Doula follows developmentally appropriate sleep practices. Formal sleep training is not performed with newborns.

  • 7. Sibling / Toddler Sleep Support

  • Are you interested in discussing sleep or transition support for another child in the home?
  • Does your child currently nap?
  • Where does your child sleep?
  • How does your child typically fall asleep?
  • How often does your child wake overnight?
  • Has your child previously participated in any form of sleep training?

  • 8. Your Home & Provider Match

  • Are there pets in the home?*
  • Are cameras or recording devices used inside the home?*
  • What qualities are most important to you in your postpartum doula?
  • Would you like an opportunity to speak with your proposed doula before confirming care?
  • How did you hear about The Envisioned Doula?*

  • Thank you!

  • Brianna will personally review your family's needs, schedule, and care preferences before your consultation. If another member of our team may be the best fit for your requested dates, we'll also begin reviewing provider availability.
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