Healthcare & Wellness

Birth Doula Services Agreement

Services agreement for a professional birth doula covering scope of non-medical support, on-call period, fees, and backup doula arrangements. Clarifies that doula services do not constitute medical care.

๐Ÿ“„ 2 signers๐Ÿ“… 30-day expiry๐Ÿท Healthcare & Wellness๐Ÿ”– doula, birth-support, labor-support, maternal-health, postpartum, childbirth

About this template

The Birth Doula Services Agreement is a ready-to-use healthcare & wellness template you can send for signature in minutes. It is written for 2 signers (client and doula) and, by default, expires 30 days after it is sent if left unsigned. It covers doula, birth support, labor support, maternal health, postpartum, childbirth. Like every Abundera Sign template it is a convenience draft structured for ESIGN Act and UETA compliance, not a substitute for legal advice. Each signed copy is sealed with PAdES-LTA digital signatures, dual RFC 3161 timestamps, and a tamper-evident evidence package in WORM storage.

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# Birth Doula Services Agreement This Birth Doula Services Agreement ("Agreement") is entered into as of ___________ by and between: **Client(s):** ___________ and ___________ (collectively "Client"), residing at ___________, telephone ___________, email ___________; and **Doula:** ___________, certified by ___________ (certification number ___________), telephone ___________, email ___________. Estimated due date: ___________. --- ## 1. Nature of Doula Services โ€” Non-Medical Scope A doula provides continuous emotional, physical, and informational support during labor and birth. **Doula services are NOT medical services.** The Doula: - Is not a licensed medical provider and does not diagnose, treat, or prescribe. - Does not perform clinical tasks such as cervical exams, fetal monitoring interpretation, or administration of medications. - Does not make medical decisions or override the decisions of the Client's medical care team. - Does not replace the care of a physician, midwife, nurse, or any licensed healthcare professional. The Client acknowledges and accepts these limitations. --- ## 2. Scope of Services The Doula agrees to provide the following services: **Prenatal support:** - ___________ prenatal visit(s), each approximately ___________ in duration, to discuss birth preferences, comfort measures, and communication strategies. - Availability by phone/text/email for questions during normal business hours beginning ___________. **Labor and birth support:** - On-call availability beginning at ___________ weeks gestation (approximately ___________) through ___________ weeks gestation or birth, whichever occurs first. - Continuous labor support from the agreed-upon call-in point through the birth and for approximately ___________ hours after delivery or until the Client is settled. - Physical comfort measures: positioning, breathing guidance, massage, counter-pressure, hydrotherapy coaching. - Emotional encouragement and advocacy for the Client's birth preferences within the medical team's constraints. **Postpartum support:**

Fields (44)

agreement date
date ยท required
client name 1
text ยท required
client name 2
text ยท required
client address
textarea ยท required
client phone
phone ยท required
client email
email ยท required
doula name
text ยท required
doula certifying org
text ยท required
doula cert number
text ยท required
doula phone
phone ยท required
doula email
email ยท required
estimated due date
date ยท required
prenatal visits count
number ยท required
prenatal visit length
text ยท required
availability start date
date ยท required
on call start weeks
number ยท required
on call start date
date ยท required
on call end weeks
number ยท required
postbirth support hours
number ยท required
postpartum visits count
number ยท required
postpartum visit window days
number ยท required
postpartum visit length
text ยท required
backup doula name
text ยท required
backup doula cert
text ยท required
birth location
text ยท required
doula call number
text ยท required
total fee
currency ยท required
deposit amount
currency ยท required
second payment amount
currency ยท required
second payment date
date ยท required
final payment amount
currency ยท required
final payment date
date ยท required
payment methods
text ยท required
cancel cutoff weeks
number ยท required
cancel refund policy
textarea ยท required
travel terms
textarea ยท required
photo permission
radio ยท required
photo license
select ยท required
testimonial permission
radio ยท required
governing state
select ยท required
client name confirm
text ยท required
client signature date
date ยท required
doula name confirm
text ยท required
doula signature date
date ยท required

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Every signed document gets PAdES-LTA digital signatures, dual RFC 3161 timestamps, and a tamper-evident evidence package sealed in WORM storage.

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