Request a Reduced Rate Postpartum Doula

The information you put into this form will go to all the postpartum doulas on the email list. You may also hear from a NAPS Doulas representative if any clarifying information is required.
Name Name First Last
Email

please include a phone number or email address so we can contact you!
City and neighborhood

we are able to offer referrals to most areas within the Puget Sound region
Zip code
How many babies will be in the home?

How many babies will be in the home? One Two/twins Three or more Other Other
Are you requesting:

Are you requesting: Virtual Support In-person Support Both/Either Not sure
Are you looking for day or overnight support?

Are you looking for day or overnight support? Days Overnights A combination of days and nights Evenings Not Sure Other Other
How many days will you need support every week?

You may not know how much support you need, and that's okay!
How many overnights will you need support every week?

You may not know how much support you need, and that's okay!
How many evenings will you need support each week (approximately 5pm-10pm timeframe, not overnight)
What is your approximate start date for your NAPS Doula?
What is the highest rate you are able to afford for a postpartum doula?

What is the highest rate you are able to afford for a postpartum doula? Pro-bono (no-cost) $10 per hour $15 per hour $20 per hour $25 per hour $30 per hour $35 per hour $40 per hour $45 per hour - Please use the form "Find a Doula" page instead if you can afford $45 or more
Additional Information: Is there any other information that would be helpful in finding you a doula? (special needs or preferences, special sibling or pet support, particular dates needed)
Is there a pet in your home? Please specify what type of pet and if the pet will be in the same room as the doula at any time. We ask this question as some of our doulas may be allergic to certain pets.
Where did you hear about NAPS?
Date Received Date Received / MM / DD YYYY
Type of Contact

Type of Contact phone email both
Primary Request

Primary Request Referral-a family is given the names of NAPS Doulas Low cost- a family or professional is sent the "reduced rate" email template Parent inquiry- a parent or family member has questions about NAPS but does not receive referrals Professional inquiry-a birth professional has questions about NAPS but does not receive referrals Member inquiry- a member or potential member has questions about membership or training
Geographic Area

Geographic Area Snohomish County (Mukilteo, Lake Stevens, Everett, Marysville) South Snohomish County (Edmonds, Lynnwood, Bothell, Mill Creek) North King (North of 85th, Greenlake to Shoreline) Monroe Area (Duvall) Eastside (Mercer Island, Bellevue, Kirkland, Redmond) Eastside (Issaquah, North Bend, Snoqualmie) Seattle (Downtown, Capitol Hill, Madison Park, All neighborhoods south of N 85th St) Seattle (Queen Anne, Magnolia, Ballard) West Seattle South Seattle (South of Sodo, Burien, Seatac, Renton) South King County (Along i-5, Federal Way, Des Moines, Fife) South King County (Along SR-167, Kent, Auburn, Covington) East Pierce County (Puyallup, South Hill, Spanaway, Bonney Lake) West Pierce (Tacoma, Lakewood, Joint Base Lewis-McChord) Peninsula (Vashon, Bainbridge, Bremerton) Outside range
Date of followup Date of followup / MM / DD YYYY
Doula referred
Doula referred
Doula referred
Additional Doula referred
Referral Completed by:
Additional notes
Type the letters you see in the image below.