Birth Photography Questionnaire
Please list your child(ren)'s name and age at EDD (Estimated Due Date)
Birth Partner's Name
Birth Partner's Contact Number
Emergency Contact Name
Emergency Contact Number
Relationship to Mother
Do you know the gender/name of your baby?
Please specify gender/name here
Estimated Due Date
Name of Primary Care Provider (midwife or doctor)
Birth Location Type
Name of Birth Location
(for hospitals and birth centers)
Birth Location Address
Street Address Line 2
What number birth is this? Please briefly describe previous birth. Do you have a history of delivering early/ late?
Have you spoken to your doctor/midwife about having a photographer attend your birth?
In the event of a C-section, have you spoken with your doctor about allowing photography in the OR?
Please list the names and relationship of anyone else you plan to have with you in your birth room.
What point of view would you like the photos to be taken?
Behind moms shoulder
Doctor / Midwife Perspective
Mixture of both
Please nominate the particular elements of the labor and birth you would specifically like me to capture?
The baby's head as it crowns
Bonding moments with specific family members
First time nursing
Would you like me to leave the room during particular situations or procedures?
Are there any goals or details within your birth plan that you would like to share with me? Knowing your plan can assist me in providing consistent support with the others in attendance.
Please tell me what the most important photos/ video moments to you.
Special requests (e.g. no talking during birth, no flash, etc)
Please specify if anyone present at your birth (apart from medical professionals)can give instructions regarding photographing process (e.g. to stop photographing, leave the room, stop using flash, etc)
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