Contact With Women


By phone:

By Mail:
With Women, LLC
P.O. Box 325
Arvada, CO 80001

Or by email


Touching belly

Your name:
Your e-mail:
Phone number:
Estimated due date:
What number baby is this for you?:
Is this a singleton or multiples pregnancy?
Do you have other children?:
Where will you be giving birth?:
Who is your care provider?:
In what part of town do you live in?:

What can we do for you? (Check as many as needed.)

Please contact me about...

I would like more information about hiring a birth doula.
I would like more information about hiring a postpartum doula.

If you would like more information about hiring a birth or postpartum doula, please fill out what pertains to you below.

Why are you seeking the care of a doula? What aspects of doula care are of interest to you?

Are there any special circumstances that may be important to consider?  For example, is this a vaginal birth after a cesarean,
are you a single parent, or is there any special medical consideration for which a doula with specific experience might be helpful?

Are you interested in interviewing with more experienced doulas, newer doulas, or perhaps you would like to meet with both?

Postpartum: Are you wanting daytime services, overnight care or both?

Postpartum: How many weeks of care, and how many days/nights per week are you interested in?

Anything else you would like to share?

How did you find out about With Women?

Thank you for taking the time to submit this form!

Statement of Intention


Birth Doulas
Postpartum Doulas


On-call Doula Program
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