Join The Birth Companions Team!

Not all information in this form will be shared publicly.

Doula application

Personal and Professional Details

Doula First Name *

Doula Last Name *

Email Address *Provide the email that you'd like TBC and clients to contact you at.

NPI #

Work Phone *

Birthday *

Languages Spoken

Home Address (please provide your exact home address with a unit # if relevant) *

Counties served *

Select every county where you offer services. Search any county nationwide.

Type of Doula Support *

Experience and Services

Years of experience *

How did you hear about us? *

If a doula referred you, please share her first and last name

Number of Postpartum Clients Served (if relevant)

Postpartum Doula Type (if relevant)

Number of Birth Clients Served (if relevant)

Insurance Eligibility *

Business Name *

Doula Fee *

Specializations

Other Services Offered

Profile Copy

Education History *

Background (this will be the bio that appears on your profile on the website) *

Uploads

Keep all photos and documents together under 40 MB.

Profile Image *

0 of 1 selected

Baby and Lifestyle Photos (optional)

Share a baby photo and 3–5 lifestyle photos, up to 8 total. These may appear on your public profile.

0 of 8 selected

Proof of Training *

0 of 3 selected

Proof of Certification

0 of 3 selected

Specialization Training Upload (optional)

0 of 3 selected

Join The Birth Companions Team!

Not all information in this form will be shared publicly.

Doula application

Personal and Professional Details

Doula First Name *

Doula Last Name *

Email Address *Provide the email that you'd like TBC and clients to contact you at.

NPI #

Work Phone *

Birthday *

Languages Spoken

Home Address (please provide your exact home address with a unit # if relevant) *

Counties served *

Select every county where you offer services. Search any county nationwide.

Type of Doula Support *

Experience and Services

Years of experience *

How did you hear about us? *

If a doula referred you, please share her first and last name

Number of Postpartum Clients Served (if relevant)

Postpartum Doula Type (if relevant)

Number of Birth Clients Served (if relevant)

Insurance Eligibility *

Business Name *

Doula Fee *

Specializations

Other Services Offered

Profile Copy

Education History *

Background (this will be the bio that appears on your profile on the website) *

Uploads

Keep all photos and documents together under 40 MB.

Profile Image *

0 of 1 selected

Baby and Lifestyle Photos (optional)

Share a baby photo and 3–5 lifestyle photos, up to 8 total. These may appear on your public profile.

0 of 8 selected

Proof of Training *

0 of 3 selected

Proof of Certification

0 of 3 selected

Specialization Training Upload (optional)

0 of 3 selected