Empowering Birth Scholarship Application
Please answer the following questions to submit your application for pro bono doula support. Now accepting applications for birthing families due in January & February 2022.
Email *
Name (First and Last) *
E-mail Address *
Phone Number *
Estimated Due Date *
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What is your ethnicity? *
Required
Please select all that apply *
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You must live in Texas to be eligible for pro bono doula support. Virtual Doula support is available for those living outside the Greater Houston area. In person support for birthing people living in the Houston area. Where do you live? (City, state & if in Houston what part of town) *
Why are you seeking doula support? *
How do you see a doula being involved in your birth? *
How will free doula services benefit you during your pregnancy & labor? *
What (if any) concerns do you have about pregnancy, labor or postpartum? *
Thank you for your interest in doula services. Spaces are limited. You will be contacted if selected to move to the next step of the application process.
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