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End-of-Life Doula Membership Form

This will be the one used in your doula directory listing

If applicable, this will be the used in the doula directory. Example: specific county served

This is the email that will be put in your website directory (if you wish to be listed)

Please list website only. Do not include FB page, IG page, or LinkedIn page as they will not be listed.
Check all that apply

Please list the percentage of your household income that comes from your doula work
Check all that apply
Check all that apply
Please check all that apply
Please check your top 3-5 reasons
Please check all that apply
Please check all that apply
I acknowledge that by agreeing to have my contact information listed on the NEDA Online Directory I may be contacted by individuals, companies, or groups not associated with NEDA. My contact information will be public and cannot be controlled by NEDA.
NEDA sends out a monthly newsletter as well as webinar announcements to members only. You always have the option to unsubscribe to the emails at any time.
NEDA Members are encouraged to join regional groups and share support and best practices with other NEDA members.

Please use a professional head shot, if possible. Do not send photos of pets or nature or social media screenshots.
"By clicking the box below, I am indicating that I understand and accept the following terms: 1) Inclusion of my information on the website directory does not constitute endorsement by NEDA or my training organization, if I have one. 2) I am fully responsible for my own contracts, promotion, and interaction with the public. 3) I have read and agree to honor the NEDA Code of Ethics, Conduct, and Scope of Practice. 4) I understand that my listing on the website directory will only be included as long as I am an active member of NEDA (renew each year)."