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Doula Client Intake Form

Have you taken a tour of your birthing place?
Any Medical Conditions Developed During Pregnancy:
Are you interested in taking Heathers Bradley Method Class?
Please check any topics you would like to discuss further:
Please check any pain management or relaxation techniques that you would NOT like to use.

Thank you!

©2018 by Every Birth Lancaster

all photos by: Meagan Nicole & Heather Gascon

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