Birth Justice Care Fund Partner Prerequisites

Birth Justice Care Fund Prerequisites
As a requirement to move forward with partnering with the Birth Justice Care Fund you will need to have completed the following:

Doula: At least 5 births completed by October 6, 2025

Lactation Support Professional: IBCLC Certificate, CLC Certificate, or CBS Certificate

Maternal Mental Health Therapist: Proof of licensure and you are practicing in one the following states – Georgia, North Carolina, Kentucky or Florida. (Please do not select this service if you aren't licensed in these states or are being supervised)
Name (first, last)*
As it appears on your ID
Preferred Name (first, last)*
Pronouns*
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
What counties do you serve?*
Which service do you provide? (Select all that apply)*

Full Spectrum DoulaBirth DoulaPostpartum DoulaLactation Support ProfessionalMaternal Mental Health TherapistFertility DoulaLoss and Bereavement doula
Have you completed the requirements listed above for EACH service you provide?*

YesNo
For Lactation Support Consultants: Please Upload Your IBCLC, CBS, or CLC Certificate For Maternal Mental Health Therapist: Please Upload Your Proof of Licensure

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Birth Justice Care Fund Prerequisites