Name *

First Name

Last Name

Phone

(###)

###

####

Address *

Used for shipping purposes only.

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Baby’s Due Date or Age (if already born):

MM

DD

YYYY

What is your biggest focus for postpartum recovery? *

Select all that apply

Rest

Emotional Healing

Nutrition

Breastfeeding Support

Community Connection

Are you willing to provide feedback on the following areas?

Select all that apply

Content clarity and flow

Visual design and layout

Practical use of the daily check-ins

Meal plan and snack suggestions

Herbal preparation instructions

Community connection opportunities

Overall ease of use

Are you open to participating in a follow-up conversation (via email, text, or group chat) to share additional insights? *

Yes

No

Participant Agreement: *

By joining this circle, you agree to: Pay a flat-rate shipping fee of $16 to receive your printed guide. Actively engage with the workbook for at least 15 days. Provide honest, thoughtful feedback via the feedback form provided. Share any creative ideas or improvements that come to mind during your use.

Yes

No