Request for a Swedish Bereavement Doula

• Swedish offers Bereavement doula services to families whose babies die in utero or who are expected to die shortly after birth. 
• This form is intended for providers, nurses, and other staff members. If you are a patient, please talk to your provider about being referred to this service. 
• Bereavement doula care is free of charge for families; it is funded by gifts from families who have had similar experiences.  
• Bereavement doulas meet with the patient prior to the birth, attend their labor & delivery, and support them for one year after the birth takes place. 
• Please enter the patient's information below to request bereavement doula services. A member of the doula services staff will be in touch with you shortly.