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Full Name *

Email *

Name of Business *

When is your due date? *

How long would you like your maternity leave to be? Please include an ideal start and end date. *

If you had to guess, roughly how many hours per month of support are you looking for? *

What would feel financially supportive and sustainable for you in this season? *

Are you currently working with a team or support staff? *

Yes

If yes, please list roles or areas they cover.

What type of support are you looking for during your leave? *

What’s your biggest hope and biggest concern about taking maternity leave? *

Is there anything else you'd like to share about your business or your vision for support during your leave?