Doula intake form: meet your client before the first visit

New clients often tell their doula more in the first message than in any form. I would rather turn that message into a few warm questions. The client answers once, in her own time, and you arrive prepared.

Who it is for

Birth doulas, postpartum doulas and small teams who take a few clients at a time.

What each question is for

Name, partner, email, phone: so you know who is in the picture and how to reach them.
Due date and birth setting: the timeline and the place you may work in.
Midwife or doctor: who else is on the team.
Support wanted: pregnancy visits, labor, postpartum, feeding, older children.
Hopes and worries: the open answers that start a real conversation.
Earlier births: what she carries from last time.
Intro call box: a gentle way to ask for a first talk.

What the client's AI would ask

"When is your baby due?" Then "Where do you hope to give birth?" Then "What do you hope a doula will help with?" It shows all answers and sends only after a yes. See agent-fillable forms.

Before you use it

Check your local privacy rules before collecting health data. This is a form, not medical advice. Read the worries answer first. A patient intake form is the clinic version, and a massage intake form shows how bodywork practices ask about comfort and safety. More in forms for clinics.

Questions

Is this the same as a birth plan?

No. An intake tells you who the client is and what support she wants. A birth plan lists wishes for the day. Many doulas send the intake first and a birth plan later.

How do I handle clients who are not sure what they need?

The services question includes I am not sure yet. Filter the CSV for that answer, then offer an intro call to those clients. A checkbox at the end lets them ask for it.

Does the form collect medical records?

No. It asks for the care provider's name and the client's own words. It does not hold records, and a doula's role is support, not medical care.

Or paste the JSON

Give this to your AI. It needs the AI Form API MCP server or an API key. It makes the form and sends you the link.

text

Create this form with the AI Form API create_form tool (or POST https://aiformapi.com/v1/forms with my API key). Then reply with the public_url.

{
  "title": "Let us get to know you",
  "description": "Tell me about you, your baby and what support would help. There are no wrong answers. I read every reply myself.",
  "fields": [
    {
      "id": "parent_name",
      "label": "Your name",
      "type": "short_text",
      "required": true,
      "max_length": 150
    },
    {
      "id": "partner_name",
      "label": "Partner or support person's name",
      "type": "short_text",
      "max_length": 150
    },
    {
      "id": "parent_email",
      "label": "Email",
      "type": "email",
      "required": true
    },
    {
      "id": "parent_phone",
      "label": "Phone",
      "type": "phone"
    },
    {
      "id": "expected_due_date",
      "label": "Due date",
      "type": "date",
      "required": true
    },
    {
      "id": "first_baby",
      "label": "Is this your first baby?",
      "type": "single_choice",
      "options": [
        "Yes",
        "No"
      ]
    },
    {
      "id": "planned_setting",
      "label": "Where do you hope to give birth?",
      "type": "single_choice",
      "options": [
        "Hospital",
        "Birth center",
        "At home",
        "Still deciding"
      ]
    },
    {
      "id": "care_provider",
      "label": "Your midwife or doctor",
      "type": "short_text",
      "max_length": 200
    },
    {
      "id": "services_wanted",
      "label": "Which support are you looking for?",
      "type": "multi_choice",
      "required": true,
      "options": [
        "Visits during pregnancy",
        "Support during labor and birth",
        "Visits after the birth",
        "Help with feeding",
        "Care for older children",
        "I am not sure yet"
      ],
      "min": 1
    },
    {
      "id": "hopes_for_support",
      "label": "What do you hope a doula will help with?",
      "type": "long_text",
      "max_length": 1500
    },
    {
      "id": "worries_now",
      "label": "Is anything worrying you right now?",
      "type": "long_text",
      "max_length": 1500
    },
    {
      "id": "earlier_births",
      "label": "If you have given birth before, how was it?",
      "type": "long_text",
      "max_length": 1500
    },
    {
      "id": "support_at_home",
      "label": "Who else will support you at home?",
      "type": "short_text",
      "max_length": 300
    },
    {
      "id": "intro_call_wanted",
      "label": "I would like a short intro call before I decide",
      "type": "checkbox"
    }
  ]
}

Or call the API

bash

curl -X POST https://aiformapi.com/v1/forms \
  -H "Authorization: Bearer $AIFORMAPI_KEY" \
  -H "Content-Type: application/json" \
  -d '{"title":"Let us get to know you","description":"Tell me about you, your baby and what support would help. There are no wrong answers. I read every reply myself.","fields":[{"id":"parent_name","label":"Your name","type":"short_text","required":true,"max_length":150},{"id":"partner_name","label":"Partner or support person'\''s name","type":"short_text","max_length":150},{"id":"parent_email","label":"Email","type":"email","required":true},{"id":"parent_phone","label":"Phone","type":"phone"},{"id":"expected_due_date","label":"Due date","type":"date","required":true},{"id":"first_baby","label":"Is this your first baby?","type":"single_choice","options":["Yes","No"]},{"id":"planned_setting","label":"Where do you hope to give birth?","type":"single_choice","options":["Hospital","Birth center","At home","Still deciding"]},{"id":"care_provider","label":"Your midwife or doctor","type":"short_text","max_length":200},{"id":"services_wanted","label":"Which support are you looking for?","type":"multi_choice","required":true,"options":["Visits during pregnancy","Support during labor and birth","Visits after the birth","Help with feeding","Care for older children","I am not sure yet"],"min":1},{"id":"hopes_for_support","label":"What do you hope a doula will help with?","type":"long_text","max_length":1500},{"id":"worries_now","label":"Is anything worrying you right now?","type":"long_text","max_length":1500},{"id":"earlier_births","label":"If you have given birth before, how was it?","type":"long_text","max_length":1500},{"id":"support_at_home","label":"Who else will support you at home?","type":"short_text","max_length":300},{"id":"intro_call_wanted","label":"I would like a short intro call before I decide","type":"checkbox"}]}'

JSON definition

json

{
  "title": "Let us get to know you",
  "description": "Tell me about you, your baby and what support would help. There are no wrong answers. I read every reply myself.",
  "fields": [
    {
      "id": "parent_name",
      "label": "Your name",
      "type": "short_text",
      "required": true,
      "max_length": 150
    },
    {
      "id": "partner_name",
      "label": "Partner or support person's name",
      "type": "short_text",
      "max_length": 150
    },
    {
      "id": "parent_email",
      "label": "Email",
      "type": "email",
      "required": true
    },
    {
      "id": "parent_phone",
      "label": "Phone",
      "type": "phone"
    },
    {
      "id": "expected_due_date",
      "label": "Due date",
      "type": "date",
      "required": true
    },
    {
      "id": "first_baby",
      "label": "Is this your first baby?",
      "type": "single_choice",
      "options": [
        "Yes",
        "No"
      ]
    },
    {
      "id": "planned_setting",
      "label": "Where do you hope to give birth?",
      "type": "single_choice",
      "options": [
        "Hospital",
        "Birth center",
        "At home",
        "Still deciding"
      ]
    },
    {
      "id": "care_provider",
      "label": "Your midwife or doctor",
      "type": "short_text",
      "max_length": 200
    },
    {
      "id": "services_wanted",
      "label": "Which support are you looking for?",
      "type": "multi_choice",
      "required": true,
      "options": [
        "Visits during pregnancy",
        "Support during labor and birth",
        "Visits after the birth",
        "Help with feeding",
        "Care for older children",
        "I am not sure yet"
      ],
      "min": 1
    },
    {
      "id": "hopes_for_support",
      "label": "What do you hope a doula will help with?",
      "type": "long_text",
      "max_length": 1500
    },
    {
      "id": "worries_now",
      "label": "Is anything worrying you right now?",
      "type": "long_text",
      "max_length": 1500
    },
    {
      "id": "earlier_births",
      "label": "If you have given birth before, how was it?",
      "type": "long_text",
      "max_length": 1500
    },
    {
      "id": "support_at_home",
      "label": "Who else will support you at home?",
      "type": "short_text",
      "max_length": 300
    },
    {
      "id": "intro_call_wanted",
      "label": "I would like a short intro call before I decide",
      "type": "checkbox"
    }
  ]
}

A doula intake form that feels like a first chat