Client Intake Form for Birth Doulas

One of the first things you will need from a new client is a completed profile of basic information. This 3-page document will collect basic contact information and also ask for information related to your client’s care during this pregnancy. You can also gather information about classes your client has taken and basic preferences for labor, birth and postpartum.

This intake form is a Microsoft Word document and can be customized by you to meet your specific needs.

Choose from a lined form that you can print, or an un-lined form, which you can email to your clients to have them complete in MS Word and then return to you via email.

For a partial preview of the first page of this document, click here:

Sample of the Client Intake Form (to print)

Sample of the Client Intake Form (to e-mail)

For the best value, a complete set of all the Savvy Doula Client Intake Forms is also available.

Following confirmation of your purchase, this form will be available for download immediately.* You will also receive an email with a link to the download page. All Savvy Doula forms come with a 7-day money back guarantee. If you are unhappy with any form you purchase, contact me for a full refund.


Client Intake Form to Print (Lined)

5.97 USD

Client Intake Form to Email (Unlined)

5.97 USD