Postpartum Doula Client Intake Forms: Everything You Need In 2024

Pregnancy and Postpartum Care for Everyone

Postpartum doula client forms are essential for gathering information about the family's needs, preferences, and expectations during the postpartum period. Here are some suggested forms for postpartum doula services:

  1. Postpartum Doula Services Agreement:
  2. Client Intake Form:
    • Contact information for the family
    • Birth details (date, location, etc.)
    • Health information for both parents
    • Information about other family members and support systems
  3. Postpartum Plan Worksheet:
    • Preferences for postpartum support
    • Daily routines and schedules
    • Specific needs and concerns
    • Goals for the postpartum period
  4. Emergency Contact Information:
    • Names and contact information for emergency contacts
  5. Communication Preferences:
    • Preferred communication method (phone, email, text)
    • Availability and preferred times for check-ins
  6. Postpartum Checklist:
    • Checklist of tasks and activities the postpartum doula can assist with (e.g., baby care, light household chores, meal preparation)
  7. Breastfeeding Support Plan:
    • Information about breastfeeding goals and challenges
    • Preferred breastfeeding positions and techniques
  8. Newborn Care Log:
    • A log for the postpartum doula to track the baby's feeding, sleeping, and diapering patterns
  9. Wellness Assessment:
    • Regular assessments of the physical and emotional well-being of the parents
  10. Postpartum Visit Checklist:
    • Checklist of topics to discuss during postpartum visits
    • Feedback and evaluation of the doula services
  11. Referral Resources:
    • Information about local resources, such as lactation consultants, pediatricians, and support groups
  12. Photography/Videography Release Form:
    • Permission to take photos or videos during postpartum support sessions

Ensure that these forms comply with local laws and regulations regarding client information and privacy. It's crucial to discuss and review these forms with clients, addressing any questions or concerns they may have. Regularly updating these documents based on feedback and changes in your practice is also recommended. Consulting with a legal professional to ensure that your forms adequately protect both you and your clients is advisable.

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Bridgette McQueen Birth Doula from Franklinton, North Carolina

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