Postpartum Client | Kearsley's Kitchen

Prenatal & Postpartum Client Form

This form is to be filled out by the mother or person expecting. Thank you for taking the a minute to fill in the following info so that I can best support you. I invite you to overshare any details that you think of! The more I know the better I can curate a care package that reflects your unique needs.

First name

Last name

Email

Phone

Address

Expected Delivery Date

How many weeks of support are you seeking? (typically 1-6!)

Names & ages of family members who will be eating from this package

Do you have any known health conditions?

Are you taking any pharmaceuticals?

this helps us understad possible herb+ drug interactions if we choose to work with herbs and teas etc.

What is your Ayurvedic Dosha? I you do not know, please follow the link below to take a quiz.

https://book.oneworldayurveda.com/free-dosha-quiz

Please list any known food allergies or intolerances

Are there foods your family loves or would like to prioritize having postpartum?

Are there foods your family DOES NOT like or would like to avoid postpartum?

Nourishing naturally sweetened foods can be restorative during the postpartum, would you like a wholesome dessert/snack as part of your menu?

Are you interested in herbal teas or peri-sprays?

Yes!

No, thanks!

Do you have food storage containers or glassware + freezer bags at home? I recommend a variety of glass tupperware that can be frozen + some soup storage & large casserole size pyrex as a start.

Yes, all sizes!

No, & we will get some

We need help figuring out what to get

Is there anything else you'd like to share?

I recognize that Kearsley is not a Doctor and is not prescribing any medication, treatment, or diagnosing illnesses. By clicking this box I agree to those terms.

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Postpartum Client Intake

Prenatal & Postpartum Client Form