CLIENT FORMS Client Forms Client Contract Registration/Intake Form Your Name (required) Your Due Date Your Partner's Name Sibling Name & Ages Your BIrth Date (Only for statistical purpose, Optional!) Your Address Your Phone Number Your Email(Required) Would You Like to Receive Our Email Newsletter? YesNo Are you.... Breastfeeding?Formula feeding? What Type of Diapers are you Using? RegularCloth Are You Taking Childbirth Education and/or Infant Care Classes? YesNo If Yes Please Let Us Know Which One? Your Doctor or Midwife's Name & Where You Will be Giving Birth? May we send them a letter letting them know simply that you are receiving our services in the postpartum period? YesNo Pediatrician Will you be returning to work outside of the home after the birth? If so, do you know approximately when? How Did You Find About Kindredmothercare? Are there any special preferences you or your family have regarding meal choices, laundry, household chores that we should know? Is there anything you think would be particularly helpful for you while under the care of Kindredmothercare? Δ