VDTA Spring 2027 PHW Training — Interest Form
Share your contact info and training preferences—then we’ll email the application, dates, and scholarship details when they’re released.
Full name
*
First Name
Last Name
Email
*
example@example.com
Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
May we text this number?
Yes
No
City and state
*
Which training site are you interested in?
*
St. Louis, MO
Jefferson City, MO
Belleville, IL
Not sure yet
Have you taken doula or perinatal health worker training before?
Yes
No
Where and when did you take prior training?
What draws you to this work?
Are you currently working in healthcare or community health?
Yes
No
What is your current role?
Would you need scholarship or payment plan information?
Yes
No
Answering yes does not affect your admission. Tuition is $5,500 and covers all program fees.
How did you hear about VDTA?
Please Select
Friend or graduate
Social media
A community organization
A provider or hospital
Event
Other
May we add you to our email list for VDTA news and future cohorts?
*
Yes
No
Submit
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