Maternal Healthcare Petition: Doula Coverage for Medicaid & Insurance
About this free form template

Access to doula care during pregnancy and childbirth has been shown to improve maternal health outcomes, reduce intervention rates, and provide crucial emotional and physical support to birthing people. Yet many insurance plans and state Medicaid programs still don't cover these essential services, creating barriers for families who need them most.

This maternal healthcare petition template makes it easy to collect signatures and advocate for doula coverage through your insurance provider or state Medicaid program. Whether you're an expectant parent, healthcare advocate, community organizer, or doula professional, this form helps you gather compelling stories and data to present to decision-makers.

The petition captures not just signatures, but the context that matters: birth plan preferences, personal experiences with maternal care, and demographic information that illustrates who is being left behind without coverage. You can share why doula support matters to you, detail your birth preferences, and add your voice to a growing movement for equitable maternal healthcare.

Built with Paperform, this template includes conditional logic to personalize the petition experience, collect eSignatures for official submissions, and automatically organize responses for advocacy campaigns. You can customize the petition language for your specific state or insurance provider, add your organization's branding, and use Stepper workflows to automatically notify coordinators when new signatures are collected or send follow-up emails to petition signers with campaign updates.

Whether you're advocating at the state level for Medicaid expansion or petitioning a private insurer to add doula services to their coverage, this template provides a professional, HIPAA-aware (though not HIPAA-compliant) way to mobilize support and create change in maternal healthcare access.

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logo_andorra_telecom_df137f1a8f.png
michelin-4.png
raywhite.png
suncorp-logo-358x104.png
unesco.png
Bitmap.png
HIR.png
HKTB-logo.png
Kenyon.png
Rice_University_Horizontal_Blue.png
accor-3.png
adp-1.png
avallain-logo-svg-160-px.png
axa-768.png
danone-2.png
deloitte-1.png
logo_andorra_telecom_df137f1a8f.png
michelin-4.png
raywhite.png
suncorp-logo-358x104.png
unesco.png
Bitmap.png
HIR.png
HKTB-logo.png
Kenyon.png
Rice_University_Horizontal_Blue.png
accor-3.png
adp-1.png
avallain-logo-svg-160-px.png
axa-768.png
danone-2.png
deloitte-1.png
logo_andorra_telecom_df137f1a8f.png
michelin-4.png
raywhite.png
suncorp-logo-358x104.png
unesco.png
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