This form is only for doulas who are already listed and now wish to change their details. If you wish to join the register do not fill in this form click on "Join the register" above.

To change your details fill out the form below, do not leave any section blank. Any section you do not wish to change on the register such as mobile phone, home address etc, type "NC" in those sections meaning "No Change"

If you wish to change your email address, send us an email using your original email address and tell us of the new one.

If you have been listed for more than 1 week, there is a $5 charge for changing your details, you will be directed to a payment page after filling in this form

We will neeed your current email address and your full name on this form for identity purposes

 
Your Full Name
Your Email Address
(the one we have for you on record)
   

Your Region
....
click the box on the right to select your main region in NZ. If you live near a border you may wish to select more than one area

 
Your Areas within
your region
In the box below type up to 5 places within your region you will travel to as a doula
(eg. towns, cities or suburbs)
 
.  
  Your Home Phone Your Mobile Phone
  Your website (if you have one)..
http://www.
     

 
--------- In the area below, please type the information for our records only ---------

This information will not be viewable by the public and will not be given to any other party. If some information is the same as above (Name, Email..etc) retype it below. Do not type "same as above"
 
Full Name
Email Address
Home Address
 
 
Home Phone
Mobile Phone
USA UK Australia
New Zealand Canada
 
 
School of Doula Training
Email or phone of school/course
Year completed course
 
         
You must fill out both the top and bottom sections before sending this form

 
 


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