Postpartum Doula Agreement
Doula's Name
*
Parent(s) Names
*
Due Date (or anticipated month of service)
Number of newborns in the home
1
2
3
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Phone Number
*
-
Area Code
Phone Number
E-mail
Select the desired package
12 hours (2-3 visits) - $450
24 hours (4-6 visits) - $875
48 hours (8-12 visits) - $1700
8 hour night (3 nights) - $1000
12 hour night (3 nights) - $1500
Custom package
Please check the box to acknowledge the following:
Postpartum doulas provide guidance to the parents including, but not limited to: infant bathing, feeding, soothing techniques, and baby wearing.
Postpartum doulas provide assistance in the home including, but not limited to: gathering and washing laundry, washing and putting away dishes, sweeping, and dusting.
Postpartum doulas may cook meals upon request, if client provides clear verbal or written instructions on how to prepare the food.
Postpartum doulas do not do the following: offer medical advice, diagnose medical conditions, take over care of baby in parents' absence,
The parents should notify the postpartum doula of baby's birth. This gives the postpartum doula a heads up that you will be scheduling your time hours soon.
The client should provide the postpartum doula with 48 hours notice of needing in-person services
Your doula is available for shifts of 4 to 6 hours per day.
If extended hours are requested (more than 6 hours at one time), another postpartum doula may be engaged to share the shift.
All postpartum hours should be used within 8 weeks of the client's due date, the date the baby comes home, or the package purchase date, whichever is later. The selected doula can not guarantee availability beyond 8 weeks.
Fees listed are for a single infant. Packages are +$50 for each additional infant.
There is a non-refundable fee of $225 if services are canceled before your due date.
If services are cancelled after your due date due to no fault of the doula, all payments are non-refundable.
If your preferred doula is unavailable, a backup doula will be provided.
Issues, cancellations and refund requests should be sent to delandra@alaboroflove.org for resolution.
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.
Venmo - send payment to @Laborofloveatl (no processing fee)
Zelle - send payment to 770-241-2078 (no processing fee)
CashApp - send payment to $laborofloveatl (no processing fee)
Electronic Invoice - processing fees apply as listed
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.
Yes to apprentice
No to apprentice
Need more information
Signature
*
Clear
My Products
Categories:
All
All
Daytime
Overnight
Blended Package
prev
next
( X )
Daytime
Postpartum Doula - 12 hours
$
235
$225 Deposit +$10 processing fee
Postpartum Doula - 24 hours
$
465
$450 Deposit +$15 processing fee
Postpartum Doula - 48 hours
$
880
$850 Deposit +$30 processing fee
Overnight
Postpartum Doula - 3 nights, 8 hours each
$
365
$350 Deposit + $15 processing fee
Postpartum Doula - 3 nights, 12 hours each
$
520
$500 Deposit + $20 processing fee
Blended Package
Combination of daytime and nighttime hours
$
365
Deposit payment of 1 night for blended hours of postpartum support
Total
$
0.00
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Submit
Should be Empty: