0
Home
Services
Blog
About
Contact
Shop
Schedule
Classes
Partner
Home
Services
Blog
About
Contact
Shop
Schedule
Classes
Partner
Login
Sign Up
Username
Password
Remember Me
Sign Up
Home
Services
Blog
About
Contact
Shop
Schedule
Classes
Partner
Home
Back Up Doula Waiver
Back Up Doula Waiver
Please enable JavaScript in your browser to complete this form.
I/We understand that if A back up doula is utilized she falls under the same protections and responsibilites as the contracts we signed for Abbey's services.
I/We understand
I/We do not understnad
I/We need more information
This protects you and the back up doula from liability.
I/We grant Abbey permission to share My/Our information with the back up doula:
I/We do grant Abbey Permission
I/We do not grant Abbey permission
I/We need more information
The back up doula will protect your privacy and not share your private information with anyone.
I/We understand that Abbey will not utilize the backup doula except in emergency situations:
I/We understand
I/We do not understand
I/We need more information
Examples of emergency situations could be if the client goes into labor early while Abbey is unavailable, Abbey is sick, ettc.
Name of Client
*
First
Last
This serves as an electronic signature
Phone number of Client
This also serves as an electronic signature.
Comment
Submit
Online Services and many Products are on sale during the COVID-19 Crisis!
Dismiss
X