Birth Doula Inquiry: Lavender & Mint Maternal Support Services

Birth Doula Inquiry Form

Are you ready to take the plunge and get the support your family deserves? Then let’s set up a free consultation so that you can learn more about me and the services I provide during pregnancy & birth.

All you need to do is fill out the form below (don’t worry, you don’t have to answer every question if you don’t feel comfortable doing so.) I will then reach out to confirm a date, time and a location to meet. I normally like to do them at a local café nearest you but online video chat meetings are available as well. I hope you are as thrilled to meet me as I am you!

Have you already scheduled your consultation? Yay, how exciting!?! I can’t wait, but first, if you could fill out the form below to your comfort level before we meet, that would be amazing.

Name*

Email Address*

Telephone Number*

Which Birth Doula Service are you interested in?
Birth Doula PackageBirth Preparation PackageEssential Oil Birth Consulting

Would you like an in-person or video chat consultation?
In-personVideo Chat

When is the estimated date of arrival for your little one(s)?

What # baby is this for you?

What is the name of the practice or care provider you are working with?

Where would you like to deliver?
HospitalHomeUnsureOther

If you plan on delivering in a hospital, which hospital?

Have there been any complications so far?

Is this birth a planned VBAC or C-Section?

Do you already know what kind of birth you are looking to have and what kind of support you are wanting from your Doula?

Do you have any questions or comments?

How did you hear about Lavender & Mint?

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Ready to schedule your free consultation?

Jodi Guererri LMT

BASED IN GENEVA, NY

jodi@lavendermintdoula.com

SERVICING THE FINGER LAKES & ROCHESTER AREAS OF NEW YORK.