Tell Us Your Story - Count the Kicks

Tell us how Count the Kicks helped you or your baby have a safe arrival.

First and Last Name*
Name of Baby(s) That was Saved*
Email Address*
Did your doctor indicate that your life was also in danger when you noticed a change in movement?*
- Yes
- No
- Unsure
Phone Number*
City
State*
Tell Us Your Story*
Upload a Photo of Your Baby
Accepted file types: jpg, png, jpeg, heic, Max. file size: 500 MB.
*
- By checking this box, I authorize Healthy Birth Day, Inc. to use my photo and story on their social media platforms, websites, newsletters and public presentations. I allow Healthy Birth Day, Inc. to edit, alter or copy this information within reason, for educational purposes and for the promotion of the Count the Kicks campaign to expectant parents.
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