AIMHiTN Doula Community Survey

AIMHiTN Doula Community Survey

Thank you for taking the time to participate in this important survey. We are working to build a stronger, more connected doula community here in Tennessee. Your input will help us understand how we can better support doulas like you and help foster an environment where professionals in our state can connect with each other. We value the incredible support you provide and want to create a space where doulas can share resources and collaborate with others. Our goal is to strengthen the community, ensuring that you have the tools and connections to thrive in your practice. Your feedback will play a vital role in shaping how we move forward in building a supportive network for all doulas in Tennessee.
Name of person completing this survey:*

First NameLast Name
Agency/Company Name*
Email*
Your email and personal information will not be shared without your permission.
We are currently building a doula directory and it is being designed to help doulas connect with each other and for families to easily find and connect with skilled doulas in their area.

Whether you're a doula looking for back-up support, mentorship, or other resources, or you are looking for the support of a doula during labor, birth, or postpartum, the aim of our directory is to provide a comprehensive listing of doulas by location and spealization ensuring that support can be found during one of the most important times in a family's life.
YesNo
Receive the "Dear Doula" monthly e-newsletterTo connect with the program coordinator to learn more about no-cost resources for doulas in TennesseeAttend or facilitate an Infant and Early Childhood Mental Health (IECMH) trainingLearn more about Infant and Early Childhood Mental Health EndorsementLearn more about Reflective Practice and its benefits for birth workersI prefer not be connect at this timeOther
Birth DoulaPostpartum DoulaNewborn Care SpecialistLactation Educator/CounselorOther
Brief description of program or services:

0/150
First time parentsTeen mothersFathersNon-English speaking familiesIndividuals with disabilitiesFamiliesSingle parentsOther
Childbirth educationBirth workPostpartum workPrenatal preparationSibling supportLactationEnd of life / GriefFertilityPlacenta EncapsulationSurrogacy / AdoptionNewborn careTrauma InformedFamilies of colorOther
Prospective client must currently be pregnantClient must be at least 12 weeks from birthClient must have established prenatal careNoneOther
EmailPhone callWebsite formOther
Do you have any associated fees or add-ons outside of your typical rate? (travel fee, specialized services, etc.) If so, please list details here:
YesNoOther
If so, please list the insurance you are able to accept.
Client homeHospitalBirth centerVirtualOther
What county is your business located in?
AndersonBedfordBentonBledsoeBlountBradleyCampbellCannonCarrollCarterCheathamChesterClaiborneClayCockeCoffeeCrockettCumberlandDavidsonDecaturDeKalbDicksonDyerFayetteFentressFranklinGibsonGilesGraingerGreenGreeneGrundyHamblenHamiltonHancockHardemanHardinHawkinsHaywoodHendersonHenryHickmanHoustonHumphreysJacksonJeffersonJohnsonKnoxLakeLauderdaleLawrenceLewisLincolnLoudonMcMinnMcNairyMarionMarshallMauryMonroeMontgomeryMooreMorganObionOvertonPerryPickettPolkPutnamRheaRoaneRobertsonRutherfordScottSequatchieSevierShelbySmithStewartSullivanSumnerTiptonTrousdaleUnicoiUnionVan BurenWarrenWashingtonWayneWeakleyWhiteWilliamsonWilsonWashingtonWilson
Business Address

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Company/Agency Website
Yes!No, but I'd like to learn more about this.No.Type option 4
Should be Empty: