The Gift of Doula Support ~Birth Scholarship Application
Birth Scholarship Application:

I believe that all birthing people should have the support of a Doula. However, there may be a financial burden that stops some people from inquiring about services. Don’t let the thought of a financial burden stop you from having the birth or support you want. Please answer the following questions to submit your application for the gift of Doula support.

LET'S DOULA THIS!
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Email *
Full Name *
Phone Number *
Best day/time to contact you? *
Required
Street Address (Zip Code included) *
(Please note that you must reside in Texas in order to be consider for the gift of Doula support. Physical or virtual support will be offered to those living within the Greater Houston Area. Those outside of the Greater Houston Area will receive virtual support).
Are you a U.S. citizen? *
Estimated Due Date (EDD): *
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DD
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Where will you be giving birth? *
How do you identify yourself? *
Required
Please select all that apply: *
Required
What services are you interested in? *
Required
Why are you seeking doula support? *
How do you feel you will benefit from having a doula? *
How will receiving this scholarship help you obtain the birth you want?   *
What concerns do you have pertaining to pregnancy, birth (labor), and/or postpartum care? *
Who is your current support system? *
How do you Woosah (relax and take a mommy moment)? 😌 *
Fun fact about you 🤪 *
Any additional comments/questions?
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