Doula Evaluation

Your experience with your SMC Doula is important to us. Thank you for taking the time to complete this evaluation — it helps us with our certification process. Your evaluation is confidential and is reviewed only by the SMC Doula Certification Team.

Important: All client evaluations must be submitted directly to SMC Doulas by the client — not by the doula. The doula must provide the client with either:

  • An addressed, postage-paid envelope to mail this completed form directly to SMC Doulas, or
  • A link to this form where the client can complete this evaluation confidentially.

If you have concerns with your doula services, please call us at (503) 281-1688 or email us at info@smcdoulas.com.

Confidential Doula Evaluation Form

Your SMC Doula Contact Information

Your Contact Information

Start Evaluation

3. Was the doula with you during the birth of your baby?
5. Did your doula make a postpartum visit on the 3rd day after the birth of your baby?
6. Did your doula provide breastfeeding support?
7. Do you think you suffered from postpartum depression?

PLEASE RATE THE SUPPORT YOUR DOULA PROVIDED (4 being the highest rating)

8. The doula was knowledgeable and skillful
9. The father/partner/family benefited from the doula
10. The doula answered your questions
11. The doula provided resources/referrals
12. The doula communicated professionally with hospital staff
13. The doula helped with breastfeeding
14. The doula provided postpartum care assistance
15. The doula improved the birthing experience
16. How satisfied are you with your doula services?
18. I am the: