Junior Doula Application
Thank you for your interest in the NOVA Birth Partners, Junior Doula Program! We are currently conducting interviews with new doula applicants. Please complete the application form. We will contact you to let you know the next steps which may include a telephone interview and an orientation. We look forward to connecting with you soon!
Email address *
First Name
Your answer
Last Name
Your answer
Best Contact Telephone Number
Your answer
What are your personal goals for volunteering as a doula with NOVA Birth Partners?
Your answer
Besides English, what other languages do you speak?
Check all that apply
Where and when did you complete your doula training?
Please list each training and the date completed. Proof of training will need to be given if accepted into the program.
Your answer
Training
Check all training(s) you have completed
Which program do you want to volunteer for?
If you have not yet attended a Birth or Postpartum doula training, when do you plan on attending training?
Training is a requirement for BOTH of our Doula programs*
Your answer
Please provide the name and number of 2 references and their relationship to you.
References can include: Private Clients, Birth Educators, Birth or Postpartum Doula Trainer(s).
Your answer
Requirements for our BIRTH DOULA program include: 1) Providing 96 hours of services (about 8 shifts). 2) Availability to remain with the client through the duration of your shift. Each birth doula shift is approximately 12 hours. 3) Completion of your shifts within one calendar year of your start date.
Are you confident that you can fulfill these requirements?
Requirements for our POSTPARTUM DOULA program include: 1) Volunteers must commit to at least 6 months of service. (2 scheduled shifts per month) 2) Each Postpartum doula shift is 4 hours at the designated hospital or the clients home. 3) Postpartum Shifts are from 10am to 2pm OR 4pm to 8pm. 5) All Postpartum Doulas must attend a mandatory training provided by NBP 6) All Volunteers must have obtained their badge prior to attending training.
Are you confident that you can fulfill these requirements?
NOVA Birth Partners serves and employs a wide diversity of people. What experiences have you had with people from cultures, backgrounds, or economic circumstances different from your own?
Your answer
Are there any patients or families you aren't comfortable working with? (i.e, religion, vaccinations, language barriers)
There's no judgement and you won't be singled out for personal choices
Your answer
In short detail, describe a few birth doula skills that you would use with a patient in labor. If you're a new birth doula, list some skills you have learned.
Your answer
In short detail, describe a few postpartum skills that you would use with a patient. If you're a new postpartum doula, list some skills you have learned.
Your answer
How did you hear about our program?
Your answer
What is your current availability?
Are you working full-time/part-time, attending school, etc? This is to ensure that we are the best fit for you.
Your answer
Are you interested/available for on-call doula work?A few times each month, we receive requests for on-call doula work where we match doulas with moms looking for more personalized support. This can include conducting prenatal and postpartum visits. Please indicate your level of interest/availability.
What else would you like us to know about you?
Your answer
When can we call you? We conduct telephone interviews with all prospective doulas.
Calls are usually conducted on Wednesday (afternoons and evenings) OR Fridays (mornings and afternoons). Please provide 2-3 different times that generally work for you on BOTH of those days. Thank you!
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service