Postpartum Doula & sleep Consultant

BETHANY ROSE ALLEN

ABOUT <font color="#90B8B0"ME

Bethany is the mother of four beautiful children, ages 6-13. She has integrated her experience of motherhood, her BS degree in Social Work, and career supporting families of newborns to formulate a method of success in meeting the distinct needs of individual families.
Bethany has been assisting families in Austin for over twenty years. Her experience began as a nanny during her college career and progressed to labor and postpartum support. She thoroughly assesses each family’s specific needs and creates a plan for multi-dimensional support. Bethany’s desire is to educate, encourage, and serve each family in a way that offers the most significant support and satisfaction for THEIR family.
With over ten years of experience as a sleep consultant, Bethany is also dedicated to helping families with “sleep shaping.” This training sets their babies up for success to make it possible to achieve longer stretches of sleep at night.
Her free time is devoted to cherishing, nurturing, educating, and investing in the lives of her four children. As a family, they create memories together by going on long walks,
playing board games, camping, and most of all, traveling. Bethany enjoys working to increase her fluency in French, playing the piano, and writing. These have become an
outlet of expression that brings joy and a deeper understanding and fulfillment to the day to day tasks of her life.

2111 Dickson Drive, Suite 20, Austin, TX 78704 | (737) 999-2336

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Lactation Consultation inquiry

Tell us a little bit about yourself.

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Partner's / Spouse's Name

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Due or Delivery Date

Are You Experiencing Any Of The Following?
Breast engorgement Plugged ducts or breast infections (like mastitis) Sore, cracked or painful nipples Milk supply concerns Struggling with nursing positions Issues with latching, tongue-tie or sucking Your baby isn't gaining weight Your baby is refusing the breast

Is This Your First Child? If Not, Did You Have Any Issues with Feeding in the Past?

What Concerns Do You Have Involving Feeding or Latch Issues?

Have You Seen a Pediatric Dentist to Diagnose Any Ties?

Are You Pumping or Supplementing with Formula?
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Please provide you contact information, and a member of our team will reach out to learn more about your needs.

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Postpartum Doula Inquiry

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How Did You Find Us?

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Estimated Due Date

I Am Looking For Postpartum Support:

Hoping to (Or Have) Delivered At:

If Delivering In A Hospital Or Birth Center, Please Provide The Name Of The Facility.

What # Baby Is This For You?

Do You Have a Doula In Mind?

Is There Anything Else You Would Like to Share With Us?

What Are You Looking For In A Doula?

What type(s) of postpartum care are you interested in?

How many weeks would you like postpartum support?

How many nights per week do you need doula support?

How many days per week do you need doula support?

Do you have pets in your home?

Do you have Carrot Fertility benefits?
yes no

Is there anything additional that you would like to tell us about your needs?

Birth Doula Inquiry

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First Name

Last Name

Email

Phone Number

Partner's / Spouse's Name

Partner's / Spouse's Phone Number

Street Address

City

State

Zip Code

Neighborhood You Live In

How Did You Find Us?

Were you referred to us by Austin Childbirth?

Care Provider

Estimated Due Date

Hope to Deliver At:

What # Baby Is This For You?

Would you be comfortable having one of our certifying doulas at your labor for silent observation and/or assisting us during your care?

Do You Have a Doula In Mind?

What Are You Looking For In A Doula?

If Delivering In a Hospital Or Birth Center, Please Provide The Name Of The Facility

Is There Anything Else You Would Like to Share With Us?

Would you prefer more or less frequent communication with your doula?
More frequent Less frequent In the middle

Are you planning to have an epidural?
Yes No Maybe Unsure

Are you planning to have any family members other than your partner present?
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Do you have a religious preference?

On a scale from 1 to 10 (very religious =1 | Very Spiritual = 10) Would you consider yourself more religious or spiritual?

Have you taken a childbirth class?
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Are you planning on taking the ABC childbirth Class?
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Are You Interested in Postpartum Doula Support As Well?

What type(s) of postpartum care are you interested in?

How many weeks would you like postpartum support?

How many nights per week do you need doula support?

How many days per week do you need doula support?

Do you have Carrot Fertility benefits?
yes no

Are you 40 years old or over?
yes no

Is there anything additional that you would like to tell us about your needs?