Birth doulas may find it helpful to have their client complete an intake form and/or a questionnaire before meeting with them for the first time. Intake forms and questionnaires help mom and the birth partner get clear on what they want for their births, and it gives valuable information to the birth doula. Birth doulas can learn more about their client’s preferences in terms of the kind of birth they want and the kind of support they desire from their doula. It also serves as a way to guide prenatal visits by helping to create a dialogue, not only between doula and clients, but between moms and their birth partners.
These downloadable forms are sold individually so that you can choose exactly what you need, or you can purchase the entire set of six forms. These forms are in Microsoft Word format so that you can customize them to better suit you and your practice. Following confirmation of your purchase, you will receive an email that will include links to download your forms immediately.*
Here is what you will find below:
- Client Intake Form – Collects basic information. Choose from one that can be printed and completed, or one that can be easily emailed and completed in Word by your client.
- Prenatal Support Intake Form – Detailed Questionnaire to be completed by Mom
- “How Can I Best Support You?” – Checklist that Mom can complete that informs her doula her desires during labor and birth
- “What Is Most Important To You To Have During Your Labor And Birth” – Mom ranks desires on a 1-5 scale of Importance on a variety of choices, to help her doula tap into Mom’s values and preferences
- “How Can Your Partner Best Support You During Labor?” – This questionnaire helps empower the Birth Partner to discover ways he can support Mom
For the best value, a complete set of all the Savvy Doula Client Intake Forms is available at the bottom of this page.
All forms come with a 30-day money back guarantee. If you are unhappy with any form you purchase, contact me for a full refund.
*Please note that some buyers have difficulty downloading forms to their mobile devices. It is recommended to download purchases directly to your laptop or desktop computer.
Have you seen:
- Initial Phone Consultation Form for Birth Doulas
- Previous Birth Experience Questionnaire
- Doula Client Services Checklist
- Client Loan Form
- Summary of Labor and Birth
- Prenatal Appointment Log
- Labor and Birth Log
- Postpartum Appointment Log
- Phone Log
- Appointment and Phone Log
- Birth Doula Contract Template to edit for your own use
- Menu of Services Template to list your service packages in detail along with prices
- Workbook that helps you to clarify your business policies, package inclusion and rates so you can easily edit the birth doula contract and menu of services