Postpartum Doula Agreement

Doula's Name

Parent(s) Names

Due Date (or anticipated month of service)

Number of newborns in the home

Other

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number

Area CodePhone Number

E-mail

Select the desired package

Please check the box to acknowledge the following:

Payment Methods: We accept several methods of payment. Some methods incur an additional processing fee. Please indicate your preferred method of payment. An electronic statement will be generated and emailed to you to keep track of all payments.

Zelle and Venmo: Zelle and Venmo are not linked to this agreement. If you wish to pay via Zelle or Venmo, complete the signature and submit your agreement. Send payment using your preferred app. Do not enter your card information below.

All methods of payment: You will receive an email with a record of your payments and balances due.

Consent to Include Apprentice - Labor of Love has apprentice doulas who appreciate having the opportunity to shadow prenatal visits, client communication, births, and postpartum support. This is at no additional cost to you. Let us know if you are willing to allow a doula to shadow any part of your experience.

Signature

My Products

Postpartum Doula deposit - $412

$400 Deposit +$12 processing fee

Total $0.00

Debit or Credit Card
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