Healthy Parents & Babies Application Form

Thank you for your interest in enrolling in our Healthy Parents & Babies program, in Illinois.

We serve families prenatally through birth, and up to age 3 for their children. Persons must be pregnant to qualify for doula services, but can be of any age and at any stage of their pregnancy. Parents can qualify for our home visiting services at any point post-birth through the age of 3 for their children. To get started in the enrollment process, please complete this initial application form and someone from our team will be in touch with you within 3-5 business days.

Note: Participation is not limited to first-time parents or new participants, but everyone must meet Early Head Start income eligibility guidelines in order to qualify.

See Eligibility Guidelines

By providing your zip code, we are able to share resources and program referrals relevant to your location.
What is your expected due date?*
What is your child's birthday?*
If you are enrolling more than one child, please click "enroll another child" to include their information.

If you have additional questions, please call 773-312-7881 or email

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