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Aspyn Wood
Religious Preference
Christian
Pagan
Agnostic
Atheist
Other (Muslim, Hindu, Buddhist, etc)
Do you want to work with someone who matches your religious choice?
Yes
No
Do you align with the LGBTQ+ community? (Self, Parent of, or Ally)
Yes
No
Are you willing to work with someone who is not in the community?
Yes
No
Are you willing to work with someone who identifies as LGBTQ+?
Yes
No
General Information Questionnaire
Pregnant
Pregnant With Multiples
Birth with Midwife
Freebirth/Homebirth
Waterbirth
Has multiple children
Infertility
Vaginal Delivery
C-Section and Recovery
VBAC
VBAC Freebirth
VBAC Homebirth
Miscarriage (Loss within the first 12 weeks)
Pregnancy Loss (12 weeks or after)
Infant Loss
Child Loss
D&C / D&E
Pregnant with Hypermobility
Teen Pregnancy (Kept Baby)
Teen Pregnancy (Gave up for Adoption and Happy with Decision)
Teen Pregnancy (Gave up for Adoption and UnHappy with Decision)
Breastfeeding
Formula Feeding
Post Partum Recovery Help
High Needs Baby
Co-Sleeping
Has/Had PCOS
Endometriosis
IVF experience
Bedrest required during pregnancy
Working Mom (outside of the home)
Stay at Home Mom
Single Mom
Mothering many (Large family mom – birthed all children)
Blended Family
Surrogate (was or is)
Cyclical Living
Alternative feminine products (cup, sponge, cloth pads, etc)
Pro Vaccination
Anti Vaccination