REQUEST SUPPORT
You can fill out the following questions to request support and a doula will be in touch to follow up. If you have questions or want to connect with us first, message us on Facebook or email us at ottawaabortiondoulas@gmail.com 
Sign in to Google to save your progress. Learn more
First Name *
Pronoun(s)
Which area of the city are you coming from? *
Please provide your contact information so a doula can follow up (email/cell/etc.). If there are any special instructions for when or how to contact you, you can leave those here, too. *
What language would you like to receive support in? (We offer services in English / Nous offrons nos services en français / Ofrecemos algunos servicios en español)
What type of support are you looking for? Select all that apply.
Do you already have an appointment scheduled?
Clear selection
All OADC services are fully confidential. However, we know that Ottawa is small. Some people prefer to access support from someone outside of their communities in order to maintain their anonymity. Others prefer support from someone who shares some of their identities or experiences. If you have a preference, please provide a detailed request here and we will do our best to accommodate.
Is there anything else you'd like to share with us?
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report