Birth and Baby Services

Offering low-cost & no-cost birth doula services


Client Forms

If you are being asked to complete the following forms, your application for our services has been approved, so Welcome! 

Before we can meet with you either in person or via video chat, we will need you to complete all of the following forms. You must also be prepared to provide us with image proof of your income eligibility with pay check stubs, AHCCCS card, WIC card or other income verification. 

HIPAA & Confidentiality Form


Image Release Form

Income Affidavit Form

Birth Environment