Doula UK

Postnatal Client Response Form

Email address of your doula's mentor*

Please ask your doula to provide this if you don't know their mentor's email address

Your Email*

Your Initials*

Name of your doula*

How did you first hear about doulas?

Why did you decide to have a doula? What was your expectation of the support they would provide?*

How did you find your doula?*

If other, please specify

Did you interview more than one doula?*

Why did you choose this particular doula?*

How do you feel about the quality of your doula's emotional support?*

Please explain your answer in more detail*

How do you feel about the quality of your doula's physical support?*

Please explain your answer in more detail*

How do you feel about the quality of your doula's support in your home?*

Please explain your answer in more detail*

How was the rapport with your doula?*

Please explain your answer in more detail*

Approximately how many hours did your doula support you for?*

Would you have a doula if you had another baby?*

Please explain your answer in more detail

What would you say to other parents considering having a doula?

Please give specific feedback about your mentored doula? Consider your doulas personality, knowledge, empathy and ability to support you in your wishes.

Do you feel your doula was mindful of (and sensitive to) your circumstances, abilities, background, race, religion, gender identity or orientation?*

Please explain your answer in more detail

If applicable, are there any comments your partner would like to add?

Fee paid to your doula*

Your doula may wish to use your words on this form to show potential clients, or as a testimonial on their website or social media. Please could you indicate whether you agree to this?*

The doula's potential clients may also appreciate contacting you for a reference. If you are happy for them to do this, please indicate below.*

Would you like to discuss any concerns with your doulas's mentor? If so, please enter your email address or telephone number here and they will be in touch.