English and Spanish speaking

Forms to be filled out


  1. Engagement Form (Fill form in for your first meeting with Polly)
  2. Doula Client Intake Form (fill in online and Submit)
  3. Birth Plan (fill in online and Submit)
  4. Release From Liability (fill in online and Submit)

1. Engagement Form


  • (Signature of birth mother and partner required)

Click here to view more details about Polly's Certifications

Trained and accredited

Copyright Polly the Doula 2015