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EOLD Membership Application

*Knowing someone's gender is essential for providing respectful and personalized care, as it may relate to religious practices, cultural traditions, or trauma-informed needs. This ensures individuals feel safe, honored, and supported in their preferences.

Ethnicity
Reason for joining the collective Required
Select your Availability & Commitment Required

Your Death Doula Credentials

In this section we are interested in learning about you and your experience. If you have not received official training or certificates, please type 'No official training' or 'No official certificates' in the respective field, and then describe your experience in the experience field.

To help us verify your credentials and ensure eligibility, please provide us with relevant documents or images for review.

Upload Image file(s)
* Upload Image files only
Upload Document file(s)
* Upload Document files only
How did you hear about the Virginia EOLD Collective?
Are you interested in group networking and peer support contact information sharing?
Would you like to be added to the online doula directory?
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Application Submission Disclaimer

By submitting this application, I hereby acknowledge and agree to the following:

  1. Adherence to Terms and Agreements: I have read and understand all terms and agreements associated with this application and the subsequent engagement (if accepted) as an end-of-life doula. I agree to abide by all terms and conditions outlined in these agreements.

  2. Ethical and Legal Practices: I understand the importance of maintaining the highest ethical and legal standards in my practice. I agree to:

    • Confidentiality: Maintain strict confidentiality regarding all client information, including medical, personal, and family details.

    • Scope of Practice: Acknowledge and respect the boundaries of my role as an end-of-life doula. I understand that I am not a medical professional and will not provide medical advice, diagnoses, or treatments.

    • Client Autonomy: Respect the client's autonomy and decisions regarding their end-of-life care.

    • Professionalism: Conduct myself professionally and respectfully at all times, maintaining appropriate boundaries with clients and their families.

    • Compliance with Laws: Adhere to all applicable laws and regulations related to end-of-life care and doula services.

  3. Disclaimer of Liability: I understand that this disclaimer does not absolve me from any liability for negligence or misconduct within the scope of my practice.

  4. Changes to Terms: I understand that the terms and agreements may be subject to change. I agree to be notified of any changes and review and acknowledge any updates as required.

VA EOLD Collective

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Virginia, USA

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