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Cart
0
About
About Us
Contact
Feedback
Request a Doula
What We Offer
services
Events
Donate
Contribute
Mutual Aid
Client Name
*
First Name
Last Name
Client Phone Number
*
(###)
###
####
Client Email
*
Age
*
When is the estimated due date?
Skip this question if you are not requesting a birth doula.
MM
DD
YYYY
City/Neighbourhood
Type of referral
*
Full funding for Doula support is only available to clients needing financial support and referred by a care provider.
Self-referral
Referral from care provider
Are you referring this client? Please include your name, relationship, and contact information.
Clients who need partial or full funding for a Doula must be referred by a care provider or community support worker. This is not required for Indigenous clients.
If this is a referral, briefly share why you think this client would benefit from having a low-cost Doula?
Select the service you are requesting
*
Labour and Birth Doula
Postpartum Doula
Abortion Doula
Pregnancy loss, miscarriage Doula
Fertility Doula
Are you requesting a Doula for yourself? Confirm you are able to cover the fee.
Yes, I can pay $1200 for a Birth Doula
Yes, I can pay $1200 or $35/hr for a Postpartum Doula
Yes, I can pay on a sliding scale $0-$350 for an Abortion Doula
When should Doula services begin if requesting postpartum, miscarriage, or abortion support?
Skip this question if you are requesting a birth doula.
Please select the Doula you would like to work with.
Any
Ozge
Ana-Luz
Brittany
Olvie
Hatice
Sage
Sarina
Karina
Marianne
Angie
Sierra
Jace
Q
Angelica
Jessica
Which language(s) are preferred for communication?
Which of the following do you identify with? (Check all that apply)
Black
Indigenous
Person of colour
Multi-racial
Newcomer/Refugee/Undocument
2SLGBTQ+
A person who uses substances
A person with a disability
Experiencing housing insecurity
Living in poverty
Is there anything you would like us to know as we process this request?
Thank you!