DOULA Contract

DOULA Contract

Doula Contract with Holding Hands Doula Services.

Shannon McQuaig

48 Ebony Street

Lacombe, Alberta T4L 0G2
DOULA (Labour Suport) CONTRACT
Mother's Name*
First Last
Father's Name*
First Last
Email*
Enter Email Confirm Email
Address*
Street Address Address Line 2 City Province Postal Code
Home Phone Number*
Cell Phone Number*
Our Baby is Due to be Born On*
Date Format: MM slash DD slash YYYY
1) Services Provided*
- Be on call for us twenty-four hours a day beginning two weeks before the due date and ending two weeks after the due date.

- Provide early labour support as requested.

- Remain with us once active labour has begun until one or two hours after the baby is born.

- Utilize non-medical support techniques for labour and birth.

- Provide physical comfort measures.

- Provide emotional support.

- Strive to maintain a calm and peaceful birth environment.

- Help us get the information necessary to make informed decisions during labour.

- Take photographs during labour, birth and recovery if we request them.

- Visit us one to two weeks after the birth to review the birth, admire the baby and get feedback on her role.
2) We Understand That The Doula Does Not*
- Perform clinical tasks, such as blood pressure, fetal pulse checks, vaginal exams, etc.

- Speak to the staff on our behalf. She will discuss any concerns with us and suggest options, however my partner and I will speak to the clinical staff.
3) Client Obligations*
- We will discuss our birth plan (written or verbal) with the doula. We will call her when labour begins so she can make arrangements to attend our birth. Usually 1/2 hour is required for the doula's travel time. If we decide not to use the doula before 38 weeks, we will forfeit the retainer fee.
4) Fees*
The fee for services described is $950.00 to be paid as followed:

- $400.00 retainer due when doula is selected and contracted is signed.

- $550.00 due at 38 weeks.

Please Note: You can eTransfer me at [email protected]
5) Agreement*
- We understand that the doula takes a limited number of clients per month in a reasonable attempt to ensure that she can make it to every client's birth without much chance of overlap or extreme fatigue. This means that she turns away potential clients once her calendar is full for that month. If a client, at the last moment decides that they do not wish to have a the services of a doula then there is usually not enough time for the doula to fill the vacant spot.

- If the doula fails to attend the birth because of unforeseen circumstances such as rapid labour, C-section or failure to call, she will still be paid the full contract amount.
Accept Terms and Conditions*
- I (Mother) agree that I have reviewed and agreed to the above terms and conditions.

DOULA Contract

Doula Contract

Shannon McQuaig

48 Ebony Street

Lacombe, Alberta T4L 0G2

DOULA (Labour Suport) CONTRACT

- Perform clinical tasks, such as blood pressure, fetal pulse checks, vaginal exams, etc.

- Speak to the staff on our behalf. She will discuss any concerns with us and suggest options, however my partner and I will speak to the clinical staff.

- We will discuss our birth plan (written or verbal) with the doula. We will call her when labour begins so she can make arrangements to attend our birth. Usually 1/2 hour is required for the doula's travel time. If we decide not to use the doula before 38 weeks, we will forfeit the retainer fee.

The fee for services described is $950.00 to be paid as followed:

- $400.00 retainer due when doula is selected and contracted is signed.

- $550.00 due at 38 weeks.

Please Note: You can eTransfer me at [email protected]

DOULA Contract

Doula Contract

Shannon McQuaig 48 Ebony Street Lacombe, Alberta T4L 0G2

DOULA (Labour Suport) CONTRACT

- Perform clinical tasks, such as blood pressure, fetal pulse checks, vaginal exams, etc. - Speak to the staff on our behalf. She will discuss any concerns with us and suggest options, however my partner and I will speak to the clinical staff.

- We will discuss our birth plan (written or verbal) with the doula. We will call her when labour begins so she can make arrangements to attend our birth. Usually 1/2 hour is required for the doula's travel time. If we decide not to use the doula before 38 weeks, we will forfeit the retainer fee.

The fee for services described is $950.00 to be paid as followed: - $400.00 retainer due when doula is selected and contracted is signed. - $550.00 due at 38 weeks. Please Note: You can eTransfer me at [email protected]

Shannon McQuaig

48 Ebony Street

Lacombe, Alberta T4L 0G2

- Perform clinical tasks, such as blood pressure, fetal pulse checks, vaginal exams, etc.

- Speak to the staff on our behalf. She will discuss any concerns with us and suggest options, however my partner and I will speak to the clinical staff.

The fee for services described is $950.00 to be paid as followed:

- $400.00 retainer due when doula is selected and contracted is signed.

- $550.00 due at 38 weeks.

Please Note: You can eTransfer me at [email protected]