POWERS Doula Resource Entry Form
After submission, someone from POWERS will be contacting you. Please note that POWERS strives to include groups and individuals that support person-centering full-spectrum healthcare. Whatever your area of doula practice and expertise, we ask that you share our commitment to supporting pregnant people as the authority over their own bodies and lives.
Email address *
Your Name
Your answer
Preferred Pronouns
Your answer
Your Business Name (if applicable)
Your answer
Location/Service Area
Your answer
Doula Services Offered
Website, if applicable
Your answer
Email address
Your answer
Phone Number
Your answer
Preferred way to be contacted by potential clients
Preferred way to be contacted by POWERS
Approximate Price of Services
Your answer
Check All That Apply:
I would like potential clients to know that I am...
I want potential clients to know about this/these other important identities that I have: (e.g. person of color, LGBTQIA, religious affiliation, other roles/titles)
Your answer
2 Sentence Bio
Your answer
Anything else you want us or potential clients to know?
Your answer
Would you like additional info about potential abortion doula trainings in Wisconsin?
Who else do you know that does doula work, supports person-centered full-spectrum healthcare, and might want to be listed on our website?
Your answer
Would you be interested in volunteering for POWERS in other roles?
If you answered "yes" to the previous question, Where do your interests/skills lie in volunteering? (The first 5 are currently our highest priorities.)
What are your ideas? We welcome your input and ideas for expanding the reach of POWERS to pregnant people throughout the state!
Your answer
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