Role of the Postpartum Doula

I will respect you, your family, your home and your parenting styles. I do NOT discipline your children.

I will not make decisions for you or speak for you though I may assist you with information and/or gently remind you of your decisions previously discussed.

I will provide non-medical physical, emotional and informational support after the birth of your baby.

I will NOT perform clinical tasks, medical assessments or evaluations nor do I provide medical advice or diagnoses for mother or baby.

My support services do not replace care from a medical provider.

I will help with self-care recovery, postpartum comfort measures, infant care, parenting information, and provides assistance with learning to feed and care for baby.

Support could include preparing simple meals and snacks, assisting with light household tasks, and other forms of support as appropriate and necessary.

I do NOT perform major housecleaning tasks (ex: washing windows, bathrooms, deep cleaning or yard work).

I am NOT able to provide transportation for mother, baby or family. I do NOT work in homes with smokers due to sensitivities.

If I am unable to provide any postpartum support due to unpredictable scheduling conflicts, I agree to either find a replacement doula or refund the deposit.

In the event of illness, emergency or severe weather, every effort will be made to reschedule services as soon as I am aware that I cannot keep our appointment. Payment for that day will be applied to future service if already paid.














Due Date:




I would like help with the following:
BreastfeedingFormula feedingPumpingCloth diaperingNewborn Care suggestions/guidanceBabywearingFood Preparation/Light mealsGrocery ShoppingLight Housekeeping (laundry, dishes, etc)ErrandsOther



Fee & Hours for Doula Services

Payment

A total of 20 hours minimum is required for postpartum care. You may select the hours you want below and add up the total or pay the retainer and use your hours as needed for the first two weeks after birth. Your retainer will be applied to your total. Payment is required before services rendered.

• My postpartum doula service fee is $35 per hour for daytime and $40 per hour for overnight
• My retainer fee is $150.00

Please check all that apply:
Day Postpartum Care - $35/hr - minimum 3 hour shiftNight Postpartum Care - $40/hr - minimum 8 hour shiftRetainer (required) - $150Advanced pay package 30 hours for $1000Postpartum Care Package 30 hours plus 2oz diaper balm (nontoxic, organic) and 8oz jar sitz bath herbs for $1025Placenta art package 30 hours plus placenta prints for $1050All-in-One Package (all of the above) $1075

Billing

There is a $150.00 deposit due at the time of signing this contract.  This is a non-refundable retainer applied to the last two weeks of services.  The services will be paid for on a weekly basis prior to services rendered. Packages must be paid In full 30 days before due date unless payment agreement has been made.  If mother/partner decides to contract the doula for more hours after the completion of this contract, she may do so pending the doulas availability.  This can occur once this contract payment is satisfied and then contracting another set of hours with 50% down at that time.

Funds

For errands and grocery shopping, please provide me with the necessary funds for items to be purchased before the errand.

Cancellation of service

Please notify me 24 hours in advance if you need to reschedule a day of service to avoid a $50.00 late-cancellation fee.  This fee does not apply in the case of a true emergency or severe weather condition cancellations. Once you have signed this contract if you decide for any reason other than a hospitalization of the mom/baby that the signed upon services are no longer needed you are still responsible for the full dollar amount of this contract, because I have put aside said time for your family and no one else’s. I will notify you 24 hours in advance if I need to reschedule service for that day due to an illness. If I am unable to be present, a back-up doula will be provided for you. I will be sure to reschedule your time for another day in the event of an illness or if you waive the back-up doula.

Scheduling

I ask that you notify me within the first 24 hours after the birth of your baby(s) so I can arrange my schedule.  At this point, I will notify you of any possible schedule conflicts.  I require 48 hours notice prior to services beginning.  Unless otherwise agreed upon and noted below. Scheduling of services are on a first come, first paid basis.

I understand that both doula and Vintage Doula make every reasonable effort to maintain my privacy coinciding with HIPAA regulations intended for hospital and clinic patient confidentiality. 

I/We have read this letter describing postpartum services and agree it reflects the discussion I/we had with her.  I/We have read all statements contained herein and I/we fully realize that I/we are signing a complete release and bar to any claims, which I/we have or believe I/we may have resulting from our contract for postpartum doula services.

I/we have read and agree with the terms and conditions described above and wish to retain the services of Tarin as my/our postpartum doula. Furthermore, I/we understand that my/our click-to-sign digital signature makes this contract legally binding.