Family/Couples/Newborn
Birth
Design
Blog
About
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Family/Couples/Newborn
Birth
Design
Blog
About
Contact
CONGRATULATIONS on your pregnancy! Thank you for taking a moment to complete this questionnaire.
Your Name
*
First Name
Last Name
Best Email Address
*
Your Phone Number
*
(###)
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What is your birth partner's name and relationship to you?
*
In the case of an emergency, what is your birth partner's phone number?
*
(###)
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What is your estimated due date?
*
Don't worry! I'm on call for the four weeks surrounding your date.
MM
DD
YYYY
What type of birth are you planning?
*
If you're not sure, just select what you THINK you'll do.
Home birth—with a midwife
Home birth—unassisted
Birth Center Birth
Hospital Birth—labor will start naturally
Hospital Birth—scheduled induction
Hospital Birth—scheduled c-section
Address where birth will take place and name of facility, if applicable.
*
Who will be with you during this birth?
Is there any notable prior birth history I should be aware of?
Feel free to tell me a little about your family and pregnancy.
*
Are there any plans or details regarding your birth plan that you would like to share with me?
Do you have any concerns regarding your birth photos?
Which Documentary Package are you considering?
Photo + Video
Photography Only
Videography Only
Grow-with-me (all inclusive, photo + video, plus maternity and newborn coverage)
PRIVACY INFORMATION
SOCIAL MEDIA AND MY WEBSITE ARE AN IMPORTANT TOOL FOR ME TO SHARE MY WORK AND INSPIRE OTHER MOTHERS, AS I'M SURE YOU EXPERIENCED WHEN YOU BEGAN YOUR SEARCH FOR A BIRTH PHOTOGRAPHER. I WOULD LOVE TO HAVE THE OPPORTUNITY TO SHARE MODEST IMAGES FROM YOUR BIRTH IN MY PORTFOLIO AND ON MY BLOG OR SOCIAL MEDIA. I TAKE YOUR PRIVACY SERIOUSLY AND WE WILL OUTLINE THE DETAILS OF WHICH PHOTOS MAY BE SHARED IN OUR CONTRACT.
Would you like to inspire other women through sharing modest photos of your birth?
*
If yes, I'd like to offer you a digital birth announcement within 24 hours of your birth.
Of Course
No, thank you.
Other Information
How did you hear about Amber DeCicco Photography? What led you to book me over other options?
Next, I will send you our contract to read over and we will set up a time to meet in person to get to know one another and answer your questions. What days and times are typically good for you?
*
Your spouse/partner is welcomed and encouraged at this meeting. Your children are welcome as well.
Thank you!
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