Newborn Client Questionnaire Name * First Name Last Name Session Date MM DD YYYY Phone * (###) ### #### Email * Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Baby's Name * Baby's Gender * Boy Girl Baby's Age at Session * Baby's current weight * Baby's Length * Including yourself, how many family member(s) are in you session? * Are there any siblings that will be participating during the session? * Yes No If you answered "Yes" to siblings participating, what are their names and ages? * Skin Conditions, if any: * Jaundice Eczema Acne Stork Bites Cradle Cap None Circumcision * Already done Scheduled for later N/A What type of childbirth delivery did you have * Vaginal Birth Natural Birth Scheduled Cesarean Unplanned Cesarean Vaginal Birth after C-Section (VBAC) Scheduled Induction Did you carry full term? * Yes No If you answered "No" to carrying full term, please indicate length of term * Does your baby have any special needs I need to be aware of? * No Yes If you answered "Yes" to special needs, please describe. * Are you breastfeeding? * Yes No Is your baby bottle fed? * Yes No Breastfeeding only (no bottle) Breastfeeding and bottle fed How is your baby feeding and how often? * Any additional comments regarding feeding that you would like to share? * Is your baby gaining weight as expected? * Yes No If you answered "No" to gaining weight as expected, any additional comments you'd like to share? * Does your baby use a pacifier? * Yes No If no, would you be opposed to using one during the session, if needed? * I highly recommend using one if the baby needs soothing during the session. Yes No Do you have any personal items that you would like to incorporate in your session? Do you have a preference on what colors are used? * Yes No If you answered "Yes" to color preferences, please describe. Does the baby’s nursery have a theme or color scheme? * Yes No If there is a nursery theme, please describe. * How do you plan on displaying your images? * Have you had professional photos taken before? * Yes No If you answered "Yes" to previously taking professional pictures, please describe your experience. * Thank you! Contact: Email:info@peanutlovephotography.comPhone:415.758.1052Address:Pittsburg, CA 94565
