PostPartum Doula & New Mom Groups
  • Due to current confidentiality regulations, all doulas should have a signed release form from their client before taking any notes about the client or the client’s labor, birth or postpartum. The best way to be fully compliant would be to get this release signed at the first prenatal visit, or upon first meeting and joining the client.

    Certification candidates should have this form signed before taking any notes. The client should receive a copy of the signed form, and the doula should have the original signed form with her/him at all times to be able to show that s/he is indeed complying with confidentiality regulations, if questioned. Confidentiality of medical and personal information obtained during the course of the doula’s work is of the utmost importance. Failure to comply with these confidentiality regulations could result in penalties.

    I give permission for my doula, Kelly Arias, to take notes about me, including personal information I choose to disclose, and information regarding my labor, birth and postpartum, as well as any information regarding my child/ren. I understand that this information may be used for the purpose of doula certification and will be shared with the Certification Committee of DONA International. I realize that this information will be shared with the doula that is providing backup support. I also understand that this information will anonymously be used by the DONA International Data Collection Committee for statistical purposes and that my doula may use this information to provide me with a summary for my own personal use.