Schedule a FREE Consultation Birth In Power Southeast Michigan (734) 407-5845empoweredbirthwork@gmail.com Name * First Name Last Name Pronouns Phone * (###) ### #### Email * I would like more information regarding... * Birth Doula Services Postpartum Doula Services Private Childbirth Education Classes Group Childbirth Education Classes Lactation Support Birth Photography Estimated due date * Planned birth location * Do you have medicaid? * Yes No If yes, please list which one... Do you identify with any of the following groups? * BIPOC Single parent Teen parent LGBTQ+ Low-income (but not on medicaid) None of these apply Anything else I should know? Thank you! I will reach out to you within 24-48 hours <3
