SMC Certification Submission - SMC Full Circle Doula Birth Companion Training, LLC

SMC Doulas Initial Certification Form

This form is for SMC Provisionally Certified Doulas who are seeking their first-time certification as an SMC Doula.

If you are already certified as an SMC Doula and are wanting to recertify, please click here.

Certification Submission

Is this the first time you will be seeking certification from SMC Doulas?

Yes, this is the first time I have applied for certification as an SMC Doula.

First Name

Last Name

Address

Street Address

Suite/Unit/Apt #

City

State / Province

ZIP / Postal Code

Email

Please use the email associated with your initial registration for the SMC Full Circle Doula Birth Companion Training.

Phone

Training Information

What was the "start date" of your training?

Upload a copy of your SMC Provsional Doula Certificate

Maximum file size: 268.44MB

Certification Requirements

Please confirm you have completed the following requirements.

Audit Requirements

Please confirm you have completed the required audit requirements.

Four (4) hours of a natural childbirth or childbirth education class or workshop

Two (2) hours of a breastfeeding/lactation class or workshop

Client Evaluation Form

Please confirm your clients will email or mail us a signed and completed Client Evaluation Form.

My clients have or will complete the confidential online evaluation form.

My clients have or will mail a signed and sealed Client Evaluation to SMC Doulas.

Certification Materials

Please upload your completed packet and all materials.

Maximum file size: 268.44MB

Only PDF files can be uploaded.

Initial Certification Fee

2 Year Initial Certification Fee

Total

Payment Information

By signing below, I certify my submission is complete and accurate. I also understand that my certification cannot be considered and awarded until my submission is complete. All certification fees are non-refundable.

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