Back Up Doula Waiver – Voices of Eve

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.

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