Business Doula Application

One-Time Payment of $1111

First Name

Last name

Business Name (if applicable)

Email

Phone

City & State

Website/Social Links

How would you describe your business (idea) right now?

Still In The Ideation Stage

Early/Emerging

Established but Evolving

In Transition or Rebuilding

What services are you currently offering (if anything)?

How long have you been in this work/business?

What drew you to this Business Doula program now?

What feels unclear, heavy, or misaligned in your business at this moment?

What kind of support are you hoping for?

How do you currently feel about receiving money for your work?

What has felt hard or painful in past business experiences?

If this program supports you well, what would feel different in your business by the end?

What would success look like in your body, not just on paper?

What kind of support resonates most with you (gentle guidance, reflection, accountability, nervous-system aware pacing, etc.)?

Is there anything you feel I should know about you before we begin?

Do you understand that this is not therapy, legal, or financial advising, but a supportive, integrative business container?

Yes

No

Is there anything else you’d like to share about yourself, your work, or why this matters to you?

By enrolling, you agree to:

• A 5-month energetic and financial commitment

• You are agreeing to a one-time installment of $1111

• All fees are non-refundable & non-transferable

• Missed payments must be resolved within 5 business days

• Visibility & promotions are offered as opportunities—not guarantees

• Membership may be revoked for ethical or community violations

By submitting this form, you consent to these terms and acknowledge your digital signature.