Family Sessions
Small Sessions
Maternity | Newborn
About
Contact
Style Guide
Family Sessions
Small Sessions
Maternity | Newborn
About
Contact
Style Guide
Southern California Family + Wedding Photography
Client Birth story Questionnaire
Estimated Due Date:
*
MM
DD
YYYY
Name
*
First Name
Last Name
Phone
*
(###)
###
####
Alternate Phone
(###)
###
####
Email
*
Partner's Name
First Name
Last Name
Partner's Phone
(###)
###
####
Partner's Email
Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Tell me about your birth (upcoming and/or past births)
Current birth plan
*
Spontaneous Labor
Induction
C-section
Location type
*
Hospital
Birth Center
Home
Other
Location Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Care Provider
*
Doctor
Midwife
Unassisted
Other
Name of Practice
*
Phone Number of Practice
*
(###)
###
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People in attendance:
*
List any person(s) that will be attending the birth of your baby for any amount of time. Check any that apply
Partner
Grandparent(s)
Doula(s)
Sibling(s)
Friend(s)
Midwife
Videographer
Other-please explain
Current Pregnancy
*
how is it progressing. check any that apply
Normal with no complications
High Risk
Preterm Labor / dilation
Some complications but no concern as of now
Other - please explain
Past Labors
*
If this is not your first labor, can you please describe how your past labor/deliveries have gone? Check any that apply.
This is my first labor
Preterm Labor
Within 1 week of EDD
Within a few days of EDD
+1 week of EDD
Quick (8 hours or less total)
Even Pace
Slow
Unmedicated
Induction
Scheduled C-Section
Emergency C-Section
Preterm Baby
Mom Interventions
Baby Interventions
Other - please explain:
Do you know the gender of your baby?
Yes, girl
Yes, boy
Yes, we are keeping it secret
No, we haven't found out
No, we are waiting until the baby is born to find out
Transfer
*
if for any reason you need to be transferred to a hospital or birth center, would you want me to:
follow
wait for instruction
Let's talk about pictures during your labor and delivery
What I would like photographed:
*
check any that apply
Labor
family in attendance
care providers - with permission
nudity ok
no nudity
crowning shot - if out of water
side shot during delivery
nursing
first bath
weight/height
foot prints
family with baby
baby with care provider/nurses
Other - please explain:
I want most of my pictures to be of:
*
my labor experience (my team helping, different positions I try, the overall scene throughout my laboring)
The moment the baby comes (surrounding minutes, reactions from me and family, the brand new baby!)
my new baby (at arrival, but also perhaps a small photo session a little while later)
i'd really just like a good mix of everything!
Social Media
As you know, social media is my largest tool for sharing my work. i would love the opportunity to share your(non-revealing) birth images in my portfolio and with my followers. but the decision is ultimately up to you, of course.
Would you like me to post a birth announcement and/or post to my stories about your birth experience?
*
An announcement would be posted within 48 hours of your birth story. a blog post will likely be published within a few weeks.
Yes, we would love that!
We would like to be the first to announce our news on social media, but you can post an announcement and blog post after we share our news.
no, thank you. we don'y plan to share much over the internet
Are you comfortable with me posting non-identifying social media updates about your labor & delivery experience?
*
Sure
It's okay as long as you are very subtle
please don't post anything
Do you want to be tagged in any images or IG stories from your birth story?
*
Yes, please do!
No, thanks i Will tag myself if I want to
Instagram Handle
Any additional comments or information?:
Thank you!
