Name *

First Name

Last Name

Partners Name

First Name

Last Name

Baby (Babies) Name

First Name

Last Name

Phone

(###)

###

####

Partners Phone

(###)

###

####

Please tick the things that bring you joy (get that oxytocin and seratonin flowing!):

movement

music

nature

cooking

gardening

dancing

talking to friends/family

cleaning

meditation

breathwork

connecting with my partner

going out for a cafe/restaurant meal

reading

having a bath

massage / pampering

journalling

being creative

lighting a candle

laughing

watching my fave shows/movies

What are the things you are open to during our time together? *

While we won't get everything done each and every visit, this helps me to understand what practical supports are going to be of value to you and your unique family.

chatting and connecting

space to ask questions and work through what's been happening

help with baby

facilitate self care

In home cooking

Already cooked meals brought in

Light tidying - common spaces

Light tidying - bedrooms

Light tidying - bathrooms

Laundry

finding ways to weave in rituals and active acknowledgement of motherhood/parenthood

play with and support other siblings

support for partner/other mother, father, parent

help to meal plan

help to get the house organised and more efficient

creative activities to fill my cup

support with feeding my baby

support with my baby and my sleep

water plants

dishes

light gardening

collecting groceries

support with postpartum nutrition

ideas for communication between partnerships and with other family members

creating and setting boundaries

support with getting out and about

foot soak and massage

draw me a bath so I can relax

face massage

facilitate meditation or mindfulness time

help out with pets, walk the dog

matrescence ceremony