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Board of Directors and Volunteers
Shaunacy King
Heather Dolimont
Vera Kevic
Norah Lynn Paddock
Kimberley Healey-Fernandez
Stephanie Alouche
Nadine Ross
Objective & Strategic Priorities
Practice Guidelines (Scope)
Equity & Inclusion Statement
Terms and Conditions
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Heather Lee Mains Memorial Award
Probono Request Form
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What is a doula?
Questions to Ask a Doula
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Member Benefits – Private page
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Event submission
Become a Doula
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Practice Guidelines
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Equity Statement
Contact Us
My Profile
About Us
Board of Directors and Volunteers
Shaunacy King
Heather Dolimont
Vera Kevic
Norah Lynn Paddock
Kimberley Healey-Fernandez
Stephanie Alouche
Nadine Ross
Objective & Strategic Priorities
Practice Guidelines (Scope)
Equity & Inclusion Statement
Terms and Conditions
Committees & Collaborations
Heather Lee Mains Memorial Award
Probono Request Form
Find A Doula
What is a doula?
Questions to Ask a Doula
Become a Member
Member Benefits
Membership
Liability Insurance FAQs
Member Benefits – Private page
News & Events
Event submission
Become a Doula
Find a Training
Policies
Grievance Policy
Practice Guidelines
Standards and Bylaws
Equity Statement
Contact Us
My Profile
Register 2020-2021
Register - 2020/2021
Step 1 of 4
25%
Important:
If you are registering as a Traditional (Aboriginal Status) member please email us instead at
certification@ontariodoulas.org
Your membership payment will be captured as an annual subscription. You will be sent a renewal reminder. You may cancel the subscription at any time.
Name
*
First
Last
Email (this will be your username as well)
*
Contact email to use on your public doula profile
*
Phone Number
*
Company Name
*
Important: This will the title of your public listing. Please enter your name if company does not apply.
Address
*
Street Address
Address Line 2
City
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Province
Postal Code
Fax (hidden)
Membership (runs Oct 1-Sept 30 and pro-rated each quarter). By registering with the AOD you have reviewed our mission statement, familiarized yourself with our Professional Code of Ethical Conduct, and Practice Guidelines. As a member of the AOD you agree to uphold collaborative professionalism at all times. This includes professional conduct towards clients, members of the AOD, non-members, the AOD Board of Directors, and any persons who you may be speaking to as a representative of the AOD or of the doula profession:*
Membership (runs Oct 1-Sept 30 and pro-rated each quarter).
*
Membership with Insurance
Membership WITHOUT insurance (ONLY available for members with existing insurance elsewhere)
Additional Professional and Commercial General Liability (membership includes $1M)
*
None ($1 million included)
$2,000,000 Additional Liability
$3,000,000 Additional Liability
$4,000,000 Additional Liability
$5,000,000 Additional Liability
Total
$ 0.00 CAD
This Doula may offer sliding scale fees to qualifying clients
*
Yes
No
This Doula may offer Pro Bono services to qualifying clients
*
Yes
No
What Doula Training Organization(s) did you train with?
*
Was this an in-person, online, or mentorship training? The AOD sets a minimum number of hours for a training/ certification to qualify for membership. This has been set to ensure professional learning has been a part of each of our members development as a doula. If your previous training/ certification does not meet the set training hours outlined below please contact the AOD for suggestions related to cross-certification or alternative options for meeting our membership criteria. Please note: the AOD does not accept self-taught doulas at this time. Click the training/ certification that applies:
*
In-person (min. of 16 instructional hours, training certificate required)
Online (min. of 20 instructional hours, certificate of completion required)
Mentorship (min. of 100 direct contact hours, letter of reference from mentor required)
How many total contact hours was your training with your instructor?
*
Instructor name and contact:
*
Is the applicant aware of any circumstances or situations where a grievance or loss of insurance was filed against the training organization and/or the instructor? If so, please explain in detail.
Does your training or certification organization require practicum hours supporting clients?
*
Yes
No
Please outline the experience you have working with clients as a professional doula.
*
Labour Doula - date of training or date of completed certification
Date Format: MM slash DD slash YYYY
If applicable
Postpartum Doula - date of training or date of completed certification
Date Format: MM slash DD slash YYYY
If applicable
I agree to receiving a free subscription to Eco Parent Magazine (member benefit, WHO Code compliant)
*
Yes
No
If you agree to receive this valuable member benefit, your information will be shared for shipping purposes.
I agree to the AOD Scope of Practice
*
Yes
No
I agree to AOD Terms and Conditions.
*
Yes
No
Have you completed an Infection Prevention and Control certificate?
*
Yes
No
Date of Infection Prevention and Control completion
*
Date Format: MM slash DD slash YYYY
Please also upload your certificate using the file upload below
Infection Prevention and Control Certificate
The AOD is recommending that all members complete an IPAC training in 2020/21. If you have not completed an IPAC training at the time of renewing/ becoming a member would you like to complete this certificate by April 30th, 2021 as an continuing education opportunity?
Yes
No
In the past, has the Applicant or any of his/her employees ever been the recipient of any allegations of professional negligence in writing or verbally?
*
Yes
No
If you answered YES, you MUST explain why below:
*
Has any insurer ever declined, cancelled or imposed special conditions for any coverage for you or your entity in the past?
*
Yes
No
If you answered YES, you MUST explain why below:
*
Is the Applicant or any of his/her employees aware of any facts, circumstances or situations which may reasonably give rise to a claim, other than advised above?
*
Yes
No
If you answered YES, you MUST explain why below:
*
2020/2021 Certificate Documents
All members, new or renewing, must upload training or certification certificates that clearly displays they have completed contact hours with their training or certification organization (required).
Please upload proof of your training or certification as a doula.
*
Accepted file types: jpg, pdf.
Proof of Insurance Document
Accepted file types: jpg, pdf.
Please include any proof of insurance documents if you have chosen to become a member of the AOD but have insurance elsewhere (all members of the AOD must have insurance for membership approval).
Additional Document
Accepted file types: jpg, pdf.
Please include any other certification document you think may be relevant.
HEREBY DECLARE that the above statements and particulars are true to the best of my knowledge, that I have not suppressed or misstated any facts and I agree that this application shall form part of the insurance policy. I also acknowledge that I am obligated to report any changes that could affect the disclosures in this application that occur after the date of signature, but prior to the effective date of coverage. I recognize that my AOD membership will auto renew on October 1st of each calendar year. I have the option to withdraw from membership prior to my yearly renewal and will receive a reminder 30 days prior to the new membership year reminding me up my upcoming fee and options for renewing.
*
Yes
Total
$ 0.00 CAD
Credit Card
*
Card Details
Cardholder Name
