Your Name *

First Name

Last Name

Cell Phone Number *

I need to add you to my contacts and enable Emergency Bypass, so my phone will ring when you text or call at 3am, and your call won't be auto-forwarded to voicemail.

(###)

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Emergency Alternate Phone Number

Just in case your phone dies but I still need your room number and access code, or get lost in the dark in your neighborhood at 3am.

(###)

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Estimated Due Date *

This helps me manage my schedule, so I can be prepared and on-call starting at 38 weeks.

MM

DD

YYYY

Social Media Privacy Preferences *

While I retain ownership of all images I capture, and retain the right to share the uncensored images of you and your baby's faces on my website portfolio, I want to respect your Social Media preferences if you have concerns about data privacy on platforms such as Instagram and Facebook. Please check each box below to approve me sharing specific types of identifying information, including you and/or baby's faces, when I post images on my social media. If ONLY the last box is checked, I may still share uncensored images from your birth here on my website that I would not share on social media. I will do my best to do so in a way that would be pretty much impossible for anyone to identify you, such as posting the album under a false name in my portfolio months later with a falsely tagged location.

You can share my first name

You can share my uncensored face

You can tag my social media username

You can share my baby's first name

You can share my baby's uncensored face

You can share the names and faces of other loved ones present

Fake names and cropped out/obscured faces only