Request Doula Tech BIRTH Doula Support
Doula Tech Birth Support Request Form

This form allows you to request a Doula Tech to support your labor and delivery journey.
Submitting this form does not guarantee a Doula Tech will attend your birth; rather, it begins the process of matching you with an available doula.

Assignments are based on several factors, including your estimated delivery date, doula team availability, monthly capacity, and prioritization of underserved medical and high-risk birthing populations.

We strongly encourage submitting your request at least 3–4 months before your due date to ensure the best possible experience, full access to birth doula support, and the complete range of GBI resources.

You will receive an update on your application within 2 weeks of submission.
If you do not receive a response within that time, please contact our Director of Doulas at doulasdo@gbiky.org or call 502-242-8370 — we’ll be happy to assist you.

Please note: Failure to respond to GBI outreach or take the next steps within 45 days of receiving your application notice will result in your application being forfeited.

Thank you for considering GBI to be part of your birth journey!
#HappyBirthing #BirthKYBetter #GBI #DoulaTech #ConnectWithADoula #ConnectWithYourCommunity

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Name of Mother/ Pregnant Person *
Phone Number *
Email Address (N/A if non applicable) *
Age *
Estimated Due Date *
MM
/
DD
/
YYYY
Zip code *
What state is your insurance set up in? *
Race/ Ethnicity *
Program/ Person of refferal *
Required
  Why are you seeking a sliding-scale or no-cost doula?   *
What type of birth are you looking to have? *
Required
Who is your insurance provider? *
Required
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This form was created inside of Granny's Girls Birth Initiative.