TLC Doula Service

  • Full Name*
  • Relaxation Questionnaire

    During relaxation, it often helps to have a "happy place" where you can go in your mind. In your ideal "happy place" what are the elements that make it the right place for you?

  • Where are you?
    Where do you picture yourself?
  • What do you have around you?
    What makes the place special to you?
  • What sounds do you hear?
    If you select music or other, describe below.
  • What do you hear?
    If you selected "other" in the above question.
  • What do you smell?
  • What are you doing?
    (sitting, walking, standing, lying down, flying, floating, etc.)
  • Is there anything else that makes this place special?
  • Security Code*

     

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