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Secure an Essential Care Session
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1. Primary Contact & Coordination Name:
*
2. Who is this critical care session for?
*
It is for me (The Mother)
It is a vital gift for a mother I want to support
3. Contact Information:
*
Email
*
4. Requested Date & Time for the 4-Hour Session:
*
Date
Time
5. Which package are you requesting?
*
4-Hour Essential Care — $240
8-Hour Essential Care — $480
12-Hour Sacred Restoration — $720
6. Focus Areas for the 4-Hour Session (Select all that apply):
*
Nutritional Preparation & Cooking (Light, comforting recovery meals)
Rest & Newborn Supervision (Watching the baby so mom can safely sleep/shower)
Household Organization & Tidying (Restoring cleanliness and structural harmony)
Emotional Grounding & Postpartum Support (Experienced, calming guidance)
7. How are you feeling right now? (Select all that apply)
*
Exhausted
Overwhelmed
Isolated and alone
Anxious
Grateful but quietly struggling
I don't even have words for it right now
All of the above
8. How do you want to feel after your session? (Select all that apply)
*
Rested
Seen and heard
Nourished
Less alone
Like myself again
Peaceful
All of the above
6. Specific Dietary Needs or Urgent Household Notes:
*
I Am Ready to Rest.
