Client Information Section
Name of the primary client (the expectant mother) @Client Name 🏷️
Our Estimated Due Date is: @Baby > Due Date 🏷️
Name of anyone else signing this contract with the mother (for instance a spouse, partner, or guardian) @Partner Name 🏷️
Please enter the phone number for the primary client. @ [___Text_box____] ✍️
Please enter the Email for the primary client for billing info etc. @ [___Text_box____] ✍️
Doula/Client Agreement Section
For a doula to be the best service for you it helps to understand the scope of what a doula does. The following are your doula’s responsibilities Please read and check all the boxes.
@[ ✔ ] ✍️ A doula accompanies children through the birth process.
@[ ✔ ] ✍️ A doula works for us, not our care provider or the hospital/birthing center.
@[ ✔ ] ✍️ A doula does not perform medical tasks.
@[ ✔ ] ✍️ A Sibling Doula is more than a babysitter. She tends to your children’s basic needs but her main function is to find ways to involve them in the birth process in person or from afar
@[ ✔ ] ✍️ Abbey will bring age appropriate educational materials including coloring pages, books, and props depending on what the client deems appropriate at a prenatal visit or video call
@[ ✔ ] ✍️ Abbey will provide support for the client’s older children from the time she is called through the duration of the time the client purchases.
@[ ✔ ] ✍️ Abbey does not drive children to or from birthing places.
This portion is to assert that you understand that what you put into doula services will strongly effect what you get out of doula services. please read and check all of the boxes. *
@[ ✔ ] ✍️ I/We understand that because Abbey is a ministry based Doula, and her fees are lower than full price doulas, she will likely be unable to provide a back up, Unless we hire one on our own or through Abbey.
@[ ✔ ] ✍️ I/We will keep Abbey informed about our desires for our children’s role in the birth as it progresses
@[ ✔ ] ✍️ I/We will contact Abbey as soon as we think we might be in labor, and to keep her informed as the labor develops even if we do not need her to come yet.
@[ ✔ ] ✍️ I/We will contact Abbey when we feel we need her, and understand that it may take 1-2 hours for her to reach us
I@[ ✔ ] ✍️ /We will discuss our preferences with Abbey and clearly state our choices to her. She will support our children’s role in the birth along with any decision we make.
@[ ✔ ] ✍️ I/We understand that this is our birth, and our children, while everything Abbey does is aimed in helping us have our desired role for our children in our birth, that can only happen if we clearly understand our options, ask questions, and state our choices/opinions to her and our health care providers.
@[ ✔ ] ✍️ If Abbey misses the labor/birth because I/we fail to contact her the entire fee will still be due. (Barring specific circumstances at Abbey’s discretion).
Name and ages of our Children @ [___Text_box____] ✍️
Fee Section
Fee Abbey Quoted to us: @Service Fee 🏷️
Discount We Qualified for:@ [___Text_box____] ✍️
@[ ✔ ] ✍️ I/We understand that If Abbey misses the labor/birth because we fail to contact her the entire fee will still be due. (Barring specific circumstances at Abbey’s discretion). The fee for Abbey’s services, through Voices of Eve.
@[ ✔ ] ✍️ I/we understand that in the event that Abbey misses the birth because of her error 25% of the total fee will be refunded(Unless we choose to substitute other services).
@[ ✔ ] ✍️ I/We understand that Abbey reserves the right to go out of town or have dates of unavailability before our on-call period. But I/We also understand that Abbey will cover those dates with us as soon as she can.
Signature of Primary Client: @Client’s Signature ✍️
Partner Signature: @Partner’s Signature ✍️
Date of signing: @Client’s Sign Date ✍️
