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About

Submit Your Cross Certification Application

Instructions

Choose the appropriate application (Birth, Postpartum, or End-of-Life Doula) below. Unless you paid for two Cross Certifications ($125 each) and passed each exam, please do not submit more than one application.
Be sure to have proof of professional doula training on hand to submit with your application. This should either be a PDF, jpg, or png file that you can upload below.
Complete the application and submit it.
We will review your application and follow up within two weeks.
PLEASE NOTE that using the wrong application or failure to accurately complete the application will delay the review process.
Do not submit more than one application unless you have paid $125 (each) for the Cross Certification and passed the related exam.

Choose the Right Application to Complete!

Choose the Birth Doula Cross Certification Application

Choose the Postpartum Doula Cross Certification Application

Choose the End-of-Life Doula Cross Certification Application

Birth Doula Cross Certification Application

"*" indicates required fields

NAME (as you would like it to appear on your certificate)*

PHONE NUMBER (in case we have questions)*

EMAIL*

CITY*

STATE*

COUNTRY (if not the USA)

PROFESSIONAL BIRTH DOULA TRAINING COMPLETED WITH ...*

TRAINING ORGANIZATION'S WEBSITE*

TRAINER'S NAME*

YEAR YOU COMPLETED DOULA TRAINING*

WAS YOUR DOULA TRAINING AT LEAST 16 HOURS IN LENGTH?*

YES

DID YOU COMPLETE A MINIMUM OF 3 HOURS TRAINING IN BREASTFEEDING BASICS & SUPPORT?*

YES

BREASTFEEDING CLASS COMPLETED WITH . . .*

YOUR NAME AT THE TIME YOU TRAINED (if different)

PLEASE UPLOAD YOUR TRAINING DOCUMENTATION*

Drop files here or

Accepted file types: jpg, png, pdf, Max. file size: 32 MB.

REQUIRED READING CHECKLIST*

Please check the books you have read. All 3 books are required.

The Birth Partner, 5th Edition, by Penny Simkin

Natural Hospital Birth, 2nd Edition, by Cynthia Gabriel

The Doula Business Guide, 4th Edition, by Patty Brennan

CERTIFICATION EXAM SCORE*

I AGREE TO ABIDE BY THE LIFESPAN DOULAS SCOPE OF PRACTICE*

YES

I AM HEREBY APPLYING TO BE A CERTIFIED BIRTH DOULA THROUGH LIFESPAN DOULAS.*

I testify that I am at least 18 years of age.

I testify that I hold a high school diploma, GED equivalency, or higher education.

I testify that my answers in this application are true.

I have attached proof of having completed professional doula training with this application.

Postpartum Doula Cross Certification Application

"*" indicates required fields

NAME (as you would like it to appear on your certificate)*

PHONE NUMBER (in case we have questions)*

EMAIL*

CITY*

STATE*

COUNTRY (if not the USA)

PROFESSIONAL POSTPARTUM DOULA TRAINING COMPLETED WITH . . .*

TRAINING ORGANIZATION'S WEBSITE*

TRAINER'S NAME*

YEAR YOU COMPLETED DOULA TRAINING*

WAS YOUR DOULA TRAINING AT LEAST 16 HOURS IN LENGTH?*

YES

YOUR NAME AT THE TIME YOU TRAINED (if different)

PLEASE UPLOAD YOUR TRAINING DOCUMENTATION*

Drop files here or

Accepted file types: jpg, png, pdf, Max. file size: 32 MB.

REQUIRED READING CHECKLIST*

Please check the books you have read. All 3 books are required.

Depression in New Mothers, 3rd Edition, by Kathleen Kendall-Tackett

The Womanly Art of Breastfeeding, 8th Edition Revised, by Wiessinger, West, and Pitman

The Doula Business Guide, 4th Edition, by Patty Brennan

CERTIFICATION EXAM SCORE*

I AGREE TO ABIDE BY THE LIFESPAN DOULAS SCOPE OF PRACTICE*

YES

I AM HEREBY APPLYING TO BE A CERTIFIED POSTPARTUM DOULA THROUGH LIFESPAN DOULAS.*

I testify that I am at least 18 years of age.

I testify that I hold a high school diploma, GED equivalency, or higher education.

I testify that my answers in this application are true.

I have attached proof of having completed professional doula training with this application.

End-of-Life Doula Cross Certification Application

"*" indicates required fields

NAME (as you would like it to appear on your certificate)*

PHONE NUMBER (in case we have questions)*

EMAIL*

City*

State*

Country (if not the USA)

PROFESSIONAL END-OF-LIFE DOULA TRAINING COMPLETED WITH ...*

TRAINING ORGANIZATION'S WEBSITE*

TRAINER'S NAME*

YEAR YOU COMPLETED DOULA TRAINING*

WAS YOUR DOULA TRAINING AT LEAST 16 HOURS IN LENGTH?*

YES

YOUR NAME AT THE TIME YOU TRAINED (IF DIFFERENT)

PLEASE UPLOAD YOUR TRAINING AND CERTIFICATION DOCUMENTATION*

Drop files here or

Accepted file types: pdf, jpg, png, Max. file size: 32 MB.

REQUIRED READING CHECKLIST*

Please check the books you have read. You must read all 3.

Being Mortal, by Atul Gawande

Stepping Stones, by Ellie Atherton

Accompanying the Dying, by Deanna Cochran

CERTIFICATION EXAM SCORE*

I AGREE TO ABIDE BY THE LIFESPAN DOULAS SCOPE OF PRACTICE*

YES

I AM HEREBY APPLYING TO BE A CERTIFIED END-OF-LIFE DOULA THROUGH LIFESPAN DOULAS.*

I testify that I am at least 18 years of age.

I testify that I hold a high school diploma, GED equivalency, or higher education.

I testify that my answers in this application are true.

I have attached proof of having completed professional doula training with this application.

FREE Webinars: Top 5 Questions about Becoming a Doula

The Doula Business Guide

End-of-Life Doula Training

Birth Doula Training

Postpartum Doula Training

Doula Certification

Doula Business Guide Online Training

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What type of doula work are you interested in?*
- Birth/postpartum topics
- End-of-life topics

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