Name *
1. What title do you use to identify yourself as an End-of-Life Worker? *
2. Are you Certified? *
If "No," would you consider Certifying?
3. If you are not certified would you find value in having an Affiliate Membership for the purpose of continuing education and networking?
4. Do you have an active Death Midwifery (or related) practice? *
5. Would you view having a nationally recognized Death Midwife Certification as valuable? *
6. Would you view continuing education/intensives provided by NACDM as valuable? *
7. Would you view having a yearly NACDM networking and teaching conference as valuable? *
8. Do you view having an organization that will advocate on behalf of Death Midwives nationally as valuable? *
9. Are you currently employed outside of your Death Midwifery practice? *

Thank you for your participation!