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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
If a Doula is not available for your due date, would you be interested in any of our other support services?
Private Childbirth Education
Pregnancy Support and Birth Planning
Postpartum Care
Meal Train
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
Tanisha Nuttal
Maria (Keka) Angelica Guerrero
Zara Mahamat
Stephanie Reid
Angelica Harley
Jessica Mcdonald
Jace Meyer
Q Roxas
Sierra Howard
Angie
Karina Villada Zepeda
Sarina Piercy
Sage Lacerte
Ana-Luz Cobon
Olvie Li
Brittany Porter
Tahia Ahmed
Hatice Sen
Marianne Lacerte
Ozge Karahasan Stephen
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!
