A. An applicant for a doula certification shall submit to the Department:
1. An application in a Department-provided format that contains:
a. The
applicant's name, date of birth, home address, telephone number, and email address;
b. The applicant's
Social Security number, as required under A.R.S. §§
25-320 and 25-502;
c. Whether the applicant has completed high school
or a high school equivalency program;
d. Whether the applicant is or has been certified as a doula in
another state or country;
e. Whether the applicant has had a certification or license revoked or
suspended by any state within the previous two years;
f. Whether the applicant is currently ineligible
for certification or licensure in any state because of a revocation or suspension;
g. Whether any
disciplinary action has been imposed by any state, territory or district in this country for an act related to the applicant's practice as a
doula;
h. Whether the applicant agrees to allow the Department to submit supplemental requests for
information under A.R.S. § 411075;
i. An attestation that the information submitted is true and
accurate; and
j. The applicant's signature and date of signature;
2. If applicable, a list of all states and countries in which the applicant is or has been certified as a
doula;
3. If a certificate or license for the applicant has been revoked or suspended by any state within
the previous two years, documentation that includes:
a. The date of the revocation or suspension,
b. The state or jurisdiction of the revocation or suspension, and
c. An
explanation of the revocation or suspension;
4. If the applicant is currently ineligible for
any occupational certificate or license in any state because of a revocation or suspension, documentation that includes:
a. The date of the ineligibility for certification or license,
b. The
state or jurisdiction of the ineligibility for certification or license, and
c. An explanation of the
ineligibility for certification or license;
5. If the applicant has been disciplined by any
state, territory, or district of this country for an act related to the applicant's practice as a doula, documentation that includes:
a. The date of the disciplinary action,
b. The state or jurisdiction of
the disciplinary action,
c. An explanation of the disciplinary action, and
d. Any other applicable documents, including a legal order or settlement agreement;
6. Documentation of the applicant's citizenship or alien status that complies with A.R.S. §
41-1080;
7. As applicable, documentation that demonstrates compliance with:
a. At least 30 hours of in-person instruction or a
combination of in-person and online in core competencies; or
b. Specific cultural training or education received
related to community training in non-western doula practices confirming completion of required core competencies; or
c. Individualized or experiential training or education
that is consistent with core competencies;
d. Practicing as a doula in this state for at least five
years, before the effective date of A.R.S. § 36-766.03, and includes:
i. Proof of current certification from a nationally
recognized doula organization; and
ii. Three letters of recommendation from a medical
provider or licensed midwife who has worked with the applicant within the preceding two years and attest to the applicant's competency;
and
e. Observing at least one birth after training is
completed;
f. Attending at least three births while serving as the
primary doula, including evaluations from the laboring mother and medical provider or licensed midwife who assisted the laboring
mother;
g. Completion of training in:
i. First aid and cardiopulmonary resuscitation,
and
ii. Neonatal resuscitation; and
h. A valid code of ethics agreement; and
i. A valid fingerprint clearance card issued according
to A.R.S. Title 41, Chapter 12, Article 3.1; and
8. A fee
specified in R9-16-909(A) and (B).
B. In lieu of the documentation required in
R9-16-902(B)(3), and (4)(a)
and (b), an applicant may submit documentation to the Department that includes:
1. The name of each state that
issued the applicant a current certification, including:
a. The certification number of each current certification,
and
b. The date each current certification was issued;
2. Documentation of the professional certificate or license issued to the applicant by each state in which the
applicant holds a professional certificate or license;
3. A statement, signed and dated by the applicant,
attesting that the applicant:
a. Has been certified or licensed in another state for at least one year, with a scope
of practice consistent of a certified doula;
b. Has met minimum education requirements specified in this
Article;
c. Has not voluntarily surrendered a certification or license in any other state or country
while under investigation for unprofessional conduct; and
d. Does not have a complaint, allegation, or
investigation pending before another regulatory entity in another state or country related to unprofessional conduct.
C. The Department may waive the minimum
training and education requirements for doula state-certification in subsections (A)(7) and (B) for applicants who shall provide documentation of
current certification with a nationally recognized doula organization.
