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Email
*
1.
First Name
2.
What is your age group?
Under 25
25-29
30-34
35-39
40-44
45+
3.
Whatās your current work situation?
Working mom
Stay-at-home mom
Other / prefer not to say
4.
Which stage of motherhood do you want the most support with right now?
*
Please select a value
Pregnancy
Child
5.
If you chose 'pregnancy', which week are you in?
Please select a value
Not applicable (I'm selecting my child's age)
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
6.
If you chose 'child', how old is your little one?
Please select a value
Not applicable (I'm selecting pregnancy)
0 weeks
1 week
2 weeks
3 weeks
4 weeks
5 weeks
6 weeks
7 weeks
8 weeks
9 weeks
10 weeks
11 weeks
12 weeks
13 weeks
14 weeks
15 weeks
16 weeks
17 weeks
18 weeks
19 weeks
20 weeks
21 weeks
22 weeks
23 weeks
24 weeks
25 weeks
6 months
6 months + 1 week
6 months + 2 weeks
6 months + 3 weeks
7 months
7 months + 1 week
7 months + 2 weeks
7 months + 3 weeks
8 months
8 months + 1 week
8 months + 2 weeks
8 months + 3 weeks
9 months
9 months + 1 week
9 months + 2 weeks
9 months + 3 weeks
10 months
10 months + 1 week
10 months + 2 weeks
10 months + 3 weeks
11 months
11 months + 1 week
11 months + 2 weeks
11 months + 3 weeks
12 months
13 months
14 months
15 months
16 months
17 months
18 months
19 months
20 months
21 months
22 months
23 months
2 years
2 years + 1 month
2 years + 2 months
2 years + 3 months
2 years + 4 months
2 years + 5 months
2 years + 6 months
2 years + 7 months
2 years + 8 months
2 years + 9 months
2 years + 10 months
2 years + 11 months
3 years
3 years + 1 month
3 years + 2 months
3 years + 3 months
3 years + 4 months
3 years + 5 months
3 years + 6 months
3 years + 7 months
3 years + 8 months
3 years + 9 months
3 years + 10 months
3 years + 11 months
4 years
4 and a half years
5 years
5 and a half years
6 years
6 and a half years
7 years
7 and a half years
8 years
9 years
10 years
11 years
12 years
13 years
14 years
15 years
16 years
17 years
18+
7.
How many kids do you have?
None yet
Pregnant with my first
1
2
3
4
5 or more
8.
Kidsā birth year(s) (optional ā select all that apply)
2026
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2011-2014
2006-2010
2000-2005
Before 2000