Client Contract
  •  

    Congratulations and thank you for choosing April's Doula Services! We're excited to support you and your family! Please remember support is available on a first come basis and is not guaranteed until the contract is signed, calendar is reviewed & invoice is paid.

    Thank you for taking the time to complete this form and reviewing the Contract Terms & Conditions of Support included.

  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
    • About Baby/Child: 
    • Estimated Due Date or Birthdate*
       / /
    • Gender*
    • About You: 
    • Type of Birth*
    • Please mark all that apply to you:
    • Birth Clients: (Postpartum, Overnight Newborn Care & Sibling Doula Clients can skip this section) 
    • Who do you plan to have present for your labor & delivery?
    • What type of pain management are you looking to have?
    • What type of comfort measures would you like to use in labor?
  • Choose your desired support below...

    • Labor & Birth Support:  
    • Labor & Birth Support

      Our Birth Doulas offer steady, compassionate support throughout pregnancy, labor, and delivery—ensuring families feel informed, empowered, and genuinely cared for every step of the way.

      As your Birth Doula, we’re here to hold space for calm, joy, and meaningful connection. However your birth unfolds, our goal is to help you feel supported and at peace—so that the memory of your baby’s one and only birth day is wrapped in light, love, and care.

      We provide evidence-based education, physical and emotional support, gentle advocacy, and lactation guidance as needed. Support begins with prenatal appointments and continues with ongoing communication via phone, text, and email. Once you reach 37 weeks, we’re officially on call until your baby arrives. We also remain available for postpartum support, helping you transition into this new chapter with confidence and care.

    • Labor & Birth Clients (Terms & Conditions of Support) 
    • Terms & Conditions of Support: Labor & Birth Clients Only


      Client Agreement

      I am contracting with April’s Doula Services for labor and/or postpartum doula care. I understand and agree to the following terms regarding the scope of support, communication, responsibilities, limitations, and fees:

      Reservation of Services

      Contracted hours are reserved on our calendar beginning at 37 weeks of pregnancy. If delivery occurs prior to 37 weeks, we will make every effort to accommodate or send a back up doula if possible. However, support availability may be subject to existing commitments during that time. In these instances, if a doula is not available to attend your pre-term birth, my doula will provide an additional 2 hours of postpartum support at no cost once I am discharged from the hospital. This can include assistance with breastfeeding, laundry, cleaning, baby care, cooking, etc. The full fee applies.

      Scope of Support

      I understand that my doula will provide emotional, physical, and informational support throughout pregnancy, labor, and the postpartum period. This includes—but is not limited to—pain coping techniques, guidance on newborn care, assistance with breastfeeding, postpartum recovery, and emotional well-being.

      During labor, my doula will support me with non-medical, non-pharmacological methods to help me cope with and progress through labor. She will offer guidance, encouragement, and physical support as needed.

      During any scheduled shifts, I understand that my doula is entitled to reasonable breaks for meals, snacks, and restroom use. These breaks will be taken thoughtfully to ensure that my care and the baby’s safety are never compromised.

      Pets & Safety

      I understand that while my doula may enjoy animals, pet behavior does not determine compatibility. If a pet is simply nervous or uncomfortable, services will continue as agreed, and no refund will be issued. However, if a pet exhibits aggressive behavior or creates an unsafe environment, April’s Doula Services reserves the right to cancel services immediately without a refund.

      Non-Medical Role

      I understand that my doula is not a medical professional and does not perform clinical tasks, including taking vital signs, performing cervical checks, or monitoring fetal heart tones. She is not responsible for the outcome of my pregnancy, labor, or postpartum experience.

      I understand that my doula will not make decisions on my behalf or speak directly to medical personnel in place of me or my partner. She will help us understand the information provided by the birth team, summarize options, and offer emotional support—but we are responsible for communicating directly with our care providers.

      Medical Care Requirement & Attendance Policy

      Clients receiving birth doula services through April’s Doula Services are required to be under the ongoing care of a licensed medical provider (OB/GYN, certified nurse midwife, licensed midwife or qualified physician) throughout pregnancy, with the intent for that provider to attend the birth.

      April’s Doula Services respects and supports each client’s right to informed decision-making and bodily autonomy. At the same time, our services are provided within clearly defined professional boundaries.

      April’s Doula Services and its team do not attend or provide support for planned freebirths or any birth in which a client intentionally chooses to forgo the presence of a licensed medical provider or certified midwife.

      In the event that a birth occurs prior to the arrival of the intended medical provider, this will be considered an unplanned circumstance and does not constitute a violation of this agreement.

      However, if a client does not secure or maintain care with a qualified medical provider, or knowingly plans to deliver without one present, April’s Doula Services reserves the right to withdraw services and may decline to attend the birth. In such cases, all fees paid are non-refundable, and any remaining balance under this agreement shall still be due.

      Clients acknowledge that April’s Doula Services and its team are non-medical support professionals and cannot be held liable for any outcomes related to the absence of medical care, prenatal care, or skilled medical attendance at birth.

      Boundaries & Right to Withdraw

      I understand that my doula may withdraw from providing services at any time if she feels uncomfortable or unsafe, with prior notice when possible. This may include issues related to behavior, environment, aggressive pets, or any factor that compromises her ability to provide safe, effective support. No refunds shall be issued.

      Payment Terms & Cancellation

      I understand that:

      My doula cannot guarantee a specific birth outcome.

      In the event of a pregnancy loss, you will need support, but it will look different than expected. Prior to 14 weeks gestation, the option to receive a full refund will be given. Once you have reached your 2nd Trimester, the retainer will be used to support you in your recovery and grieving. You may choose to purchase the entire package, change the hours of support, surrender or gift to another family.

      I understand that if my doula fails to attend my birth due to unforeseen "Acts of God" such as impassable road conditions, fallen trees, etc., no refund shall be issued. 

      If I decide not to use a doula prior to 37 weeks, I will not owe the remaining balance, but the Retainer Fee is non-refundable.

      If I deliver by cesarean birth and choose not to have my doula present, or if hospital or physician policies prevent her presence, I am still responsible for full payment. 

      *Please note that under the circumstances of a cesarean birth, a doula can generally provide support to you before and after your cesarean section birth. If the situation prevents the doula from supporting during labor or to be present during the cesarean section, one postpartum session will be provided to help you around the house as well as with the newborn and breastfeeding.

      I understand if my doula is unable to attend my birth due to a rapid labor (baby is born less than three hours after I call the doula and ask her to come), or I give birth before 37 weeks, I will receive two hours of postpartum support after hospital discharge. Full payment is still required.

      My doula will do her best to arrive at my home or birth location as soon as she is able, after being notified. I agree to provide at least three hours notice whenever possible to allow time for her to make arrangements.

      Backup Support

      I understand that it is my responsibility to call (not text) my doula (or back-up doula, if there was one established) when I am ready for labor support or designate someone to make that call on my behalf.

      If my doula becomes ill, needs rest, or is unable to continue providing high-quality support due to an extended labor, she will contact a backup doula at no additional cost to me. I have the right to decline backup support; however, I understand that full payment for contracted services is still required.

      If for any reason my doula (or back-up doula, if there was one established) fail to attend my birth during the on-call period (37–42 weeks), and I requested their support by phone call within 3 hrs of birth, I will be returned the pro-rated birth portion of the contract.

      In the unforeseen circumstance that my doula (or back-up doula, if there was one established) is not reachable after 30 min of attempting to call for labor support, I will call the Agency number.

      Agency Numbers 864-712-5712 or 864-518-9521 or 864-556-7045

      All effort will be made to accomodate the client's preferences whether it be based on personality, experience, religious preferences, etc. The agency will use its best discretion and decision-making abilities to fulfill the contract and support needs of the client. I have the right to decline backup support; however, I understand that full payment for contracted services is still required.

      The Agency agrees to provide back-up doula support to me within 3 hrs of the call to the Agency or the prorated portion of the birth will be refunded.

      I understand that if my doula or a back-up doula are unable to attend my birth due to a precipitous birth (baby is born less than three hours after I call the doula and ask her to come), or I give birth before 37 weeks, I will receive two hours of postpartum support after hospital discharge. Full payment is still required.

      Release of Liability

      I acknowledge that April’s Doula Services and any affiliated doulas are not liable for any aspect of medical care received during my pregnancy, labor, birth, or postpartum period. I release them from responsibility for outcomes related to medical care provided by my healthcare providers or birth facility.

      Independent Contractor & Fee Structure

      I understand that my doula may be an independent contractor working through April’s Doula Services. While April’s Doula Services coordinates care and ensures a high standard, my doula operates independently. A portion of my payment goes toward administrative and coordination fees retained by April’s Doula Services.

      If I have any questions regarding this arrangement, I understand I may reach out for clarification at any time.

      Agreement to Terms & Conditions

      I have read and understand all terms and conditions outlined above. I understand that support is not guaranteed until availability is confirmed and the 50% non-refundable retainer has been paid. I accept full responsibility for payment of all contracted services.

      By signing below, I agree to the Terms & Conditions of Support with April’s Doula Services.

    • Postpartum-Daytime Support:  
    • Daytime Postpartum Support

      Our daytime doula care offers the steady presence of an expert, paired with the warmth of an experienced friend or nurturing mother figure—someone to lean on during one of the most vulnerable, emotional, and beautiful times in a woman’s life. Sometimes, all it takes is a cup of tea, a listening ear, and time to rest for the body and soul to begin healing.

      As your Postpartum Doula and Newborn Care Specialist, we provide personalized support tailored to your family’s unique needs. A typical daytime shift lasts 3–4 hours and may include:

      Light housekeeping
      Laundry & baby laundry
      Meal preparation or cooking
      Nursery setup & organization
      Sibling support
      Newborn care & soothing techniques
      Infant feeding & lactation support
      Preparing sitz baths or herbal healing care
      Encouraging parental rest & self-care


      This is a time to be nurtured—day support helps ease the physical and emotional transition into parenthood with calm, capable care.

      Please note: The type of support provided may vary based on the doula you contract with and the care preferences discussed during your consultation.

    • Postpartum-Sunrise & Sunset Support:  
    • Sunrise & Sunset Support

      *Please Note: Sunrise and Sunset Support availability is determined at the discretion of the individual doula. Some doulas may offer these shifts as standalone services, while others may require that they be scheduled in conjunction with Overnight Support. Whether there can be a combination of Sunrise and Sunset hours is also based on the doula’s availability and preference.

      These transitional care windows are designed to ease the most demanding parts of your day—mornings and evenings—so your family can start and end the day with less stress and more support.

      Sunrise Support offers a gentle start to your morning with an extra set of capable hands. Whether it’s preparing breakfast, tidying up the kitchen, getting baby ready for the day, or holding baby so you can shower, get dressed, or catch up on rest, this time is all about lightening your morning load and helping you feel more grounded before the day begins.

      Sunset Support brings calm and support to the evening chaos. From preparing and cleaning up dinner to helping with bath time, prepping meals for the next day, or caring for baby while your family winds down—this is the golden hour of care that helps set the stage for a more peaceful night ahead.

      Our Sunrise & Sunset Support helps restore rhythm to your day with attentive, practical, and nurturing care when you need it most.

    • Postpartum-Overnight Support:  
    • Overnight Support-Postpartum Support

      There’s nothing quite like the peace of knowing a trusted, experienced professional is caring for your baby while you rest. Our Overnight Support offers the comfort of an expert and the steady presence of a nurturing mother, sister, or experienced friend—someone who intuitively knows how to tend to your baby’s needs and gently support your recovery through the night.

      A typical overnight shift includes:

      Newborn care & soothing
      Diaper changes
      Infant feeding & lactation support
      Cleaning bottles & pump parts
      Baby laundry as needed

      We follow your baby’s rhythm throughout the night and sleep when your baby sleeps. To provide safe, attentive care, a horizontal sleeping surface must be provided for the doula to rest.

    • Postpartum Clients (Terms & Conditions of Support)  
    • Terms & Conditions of Support: Postpartum Clients

      *I understand that unless otherwise agreed upon, a responsible, unimpaired individual will be in the home during a shift in the event we are called to a birth or have to leave unexpectedly to due sickness.

      *I understand that due to scheduling purposes, the total of all postpartum hours must be used by their alloted support timeframe from the start of postpartum support. (unless previously discussed). If there are any leftover hours, those hours would expire and be relinquished. Depending on availability, new hours would need to be purchased in order to extend support.

      *I understand that depending on availability, contracts may be extended with a new package or additional hours may be purchased and paid for on a weekly basis.

      *I understand that if the doula arrives and no one is home to answer the door, they will attempt to contact me. If there has been no communication from me after 15 min from the first attempt, the support shift is considered canceled and no refund will be issued.  

      *I understand that holidays can effect scheduling and the amount of support days available for me that week, regardless of the number of days discussed during consultation and contracted for.

      *I understand that in order to support their well-being and ensure their highest quality of care, doulas are entitled to reasonable restroom breaks and may take time to eat meals or snacks during any shift. Doulas will do their best to choose appropriate times for breaks, ensuring that the safety and care of the baby or client are never compromised.

      *I understand that in order for my doula to arrive on time and provide consistent, high-quality care, I am responsible for ensuring safe, legal, and reasonably accessible parking is available during scheduled support hours.

      *I understand that if parking is not available at or near my home, birth location, or service site, I agree to cover the cost of a rideshare from a nearby safe and legal parking location.

      *I understand that if a hospital, residential, or public parking garage must be used, I am responsible for all associated parking fees.

      *I understand that if my doula receives a parking ticket, citation, towing fee, or fine as a result of parking in a location I directed or approved, I am responsible for reimbursing those costs.

      *I understand that lack of reasonable parking access may result in delayed arrival or interruption of support, and that my doula will not be held responsible in these circumstances and time missed will be forfeited.

      *I understand that sicknesses of the doula, in their household and in client households occur and can not be avoided. Cancellation is at the discretion of myself or the doula and will be rescheduled, possibly added to the end of the contract.

      *I understand that once the contract is signed and reatiner is received, my support dates are reserved on the doulas schedule.

      *I understand that unplanned guests arriving to visit or help care for family & baby as well as poor planning and/or communication can all negatively effect scheduling and the support my doula and her team can offer to other families. Therefore, shifts may be forfeited & cancellation fees may be assessed for cancellations with less than 48 hr notice.

      *I understand that postponing, delaying and/or rearranging of scheduled support dates and times for any reason withthe exception of sickness, has an effect on scheduling. My doula will make all reasonable efforts to work with these changes, however, if the accomodations can not be made and the shifts are not able to be rescheduled within the timeframe required or available, those shift may be forfeited and no refund is due.

      *I understand that in the event the doula has to leave during a support shift due to being called to a birth, due to sickness or medical reason for herself or a family member, unfulfilled hours will be rescheduled.

      *I understand that in the event the doula needs assistance in fullfilling support hours due to, but not limited to an emergency, sickness, attending a birth, unexpected injury and/or temporary physical limitations, or scheduling purposes, she may, at her discretion and at no expense to the client, send a backup or bring an assistant with her to fullfill support.

      In the unforeseen circumstance that my doula (or back-up doula, if there was one established) is not reachable after 30 min of her arrival time, I will call the Agency number.

      Agency Numbers 864-712-5712 or 864-518-9521 or 864-556-7045

      *I understand that in the event of a pregnancy loss, I will need support, but it will look different than expected. Prior to 12 weeks gestation, the option to receive a full refund will be given. Once I have reached my 2nd Trimester, the retainer will be used to support me in my recovery and grieving. I will have the option to choose to purchase the entire package, change the hours of support, or surrender (gift to another family)

      *In the event that you choose to surrender unused hours, (not to be mistaken for expired hours that are relinquished) you may:

            -Gift the unused hours to a friend or family member

            -Donate the hours to support a client who can not afford the support

            -Place the hours in a lottery to choose someone at random

      Pets & Safety

      I understand that while my doula may enjoy animals, pet behavior does not determine compatibility. Pets can sense changes in a home with a new baby and a new person in the home. I understand that cleaning up after my pet is outside of the scope of my doula's support. I acknowledge that it may become necessary to keep my pet in a seperate room than the doula while she is there for her shift. If my pet is simply nervous or uncomfortable, services will continue as agreed or can be cancelled by the client, but no refund will be issued. However, if my pet exhibits aggressive behavior or creates an unsafe environment, April’s Doula Services reserves the right to cancel services immediately without a refund.

      I understand that I have full autonomy in making decisions for my child, and I trust that my doula will respect and support those choices. In the rare event that my doula recommends immediate medical evaluation and I choose not to pursue it, I agree that she cannot be held liable for any outcomes resulting from that decision.

      If my doula determines that a situation is outside the scope of her professional expertise or training, she will inform me directly and may, at her discretion, end the shift early to maintain safe and appropriate boundaries. I understand that any remaining time in that shift will be forfeited. My doula may resume care once the concern has resolved or after I provide documentation from my child’s doctor confirming that the condition is not contagious or life-threatening.

      I understand that my doula follows the current safety guidelines outlined by the Centers for Disease Control and Prevention (CDC) and the American Academy of Pediatrics (AAP). If I choose to follow care practices outside of those guidelines, I agree to provide written instructions from a licensed pediatrician. This ensures that care remains safe, informed, and aligned with evidence-based medical standards.

      Payment Terms & Cancellation

      I understand that the following circumstances would result in no refund being issued and may lead to the cancellation of this contract:

      *If client decides not to have doula for postpartum support

      *If doula feels threatened, feels unsafe

      *If doula feels the baby is being denied food for any reason

      *If reasonably comfortable, clean, smoke-free, overnight accomodations are not provided to doula. It is at the doulas discretion whether the contract is cancelled with no refund or if the contract is changed to a different type of support. 

      *If home is not reasonably clean, smoke-free, and free of rodents, pests, pet feces, or strong odors such as cat urine.

      *If client chooses not to use/schedule the remainder of support hours due to baby sleeping an extended period of time

      *If immediate medical treatment is declined & the medical situation is deemed out of scope of the doulas expertise, the doula has the right to leave during a shift and those hours will not be rescheduled. 

      Reservation of Services

      Contracted hours are reserved on our calendar beginning at 37 weeks of pregnancy. If delivery occurs prior to 37 weeks, we will make every effort to accommodate. However, support availability may be subject to existing commitments during that time.

      Independent Contractor & Fee Structure

      I understand that my doula may be an independent contractor working through April’s Doula Services. While April’s Doula Services coordinates care and ensures a high standard, my doula operates independently. A portion of my payment goes toward administrative and coordination fees retained by April’s Doula Services.

      If I have any questions regarding this arrangement, I understand I may reach out for clarification at any time.

      Release of Liability

      I acknowledge that April’s Doula Services and any affiliated doulas are not liable for any aspect of medical care received during my pregnancy, labor, birth, or postpartum period. I release them from responsibility for outcomes related to medical care provided by my healthcare providers or birth facility.

      Agreement of Terms & Conditions

      I have read and understand all terms and conditions outlined above. I understand that support is not guaranteed until availability is confirmed and the 50% non-refundable retainer has been paid. I accept full responsibility for payment of all contracted services.

      By signing below, I agree to the Terms & Conditions of Support with April’s Doula Services.

    • Sibling Doula Support:  
    • Sibling Doula Support

      Welcoming a new baby is a beautiful moment—but it can be a scramble figuring out who will love on your older children while you’re giving birth. Our Sibling Support offers reliable, nurturing, on-call care starting at 37 weeks and continuing until your baby arrives. We step in to care for your children, managing the home, preparing meals, keeping routines steady, and ensuring your family feels safe and supported while you focus on the birth.

      Our sibling doulas have On-Call Availability starting 37 weeks and arrange a meet and greet, playdate prior to birth. They provide calm, consistent childcare and home support during the birth of your new baby. Your children’s routines stay intact, meals and bedtime/naptime are handled, and the home runs smoothly while you head to the hospital.

      This is a time to be nurtured—sibling support helps ease the transition with calm, capable care.

      If you need support beyond your package, additional hours may be added at $45 per hour, upon availability and will be billed accordingly.

      As your Sibling Doula, we provide personalized support tailored to your family’s unique needs. We will schedule a Meet & Greet Playdate to get acquainted before the big day.

      Support may include:

      Light household tasks

      Tidying Up

      Laundry

      Dishes

      Meal preparation or cooking

      Bedtime and/or morning routine support

      Age appropriate education on the birth of their new baby

      *Please note: The type of support provided may vary based on the doula you contract with and the care preferences discussed during your consultation.

       

    • Classes:  
    • Placenta Products: 
    • The processing of your placenta is done by a certified placenta expert, trained and certified in blood borne pathogens with a food handler's certification. Your placenta is process and handled with OSHA compliant safety measures.

      We offer a gentle method of placenta encapsulation using the Traditional Chinese Medicine (TCM) steaming method. This approach gently steams the placenta with warming herbs before dehydration, a practice rooted in centuries of traditional use. It is believed to support balance, warmth, and recovery during the postpartum period.

      If you're interested in the method of raw encapsulation or steaming without the addition of herbs, we can accomodate that as well.

      *Placenta products and herbal preparations are not evaluated or approved by the FDA and should not be considered medical treatment for any physical or emotional concerns. Please speak with your healthcare provider before using these or any herbal supplements.

      *If there is a medical issue that arises making your placenta unsafe to encapsulate, you will be refunded. 

    • Placenta Product Clients (Terms & Conditions of Support)  
    • Terms & Conditions of Support: Placenta Product Clients


      Client Agreement

      I am contracting with April’s Doula Services for placenta processing. This process may include but not limit to encapsulation, salves, tinctures, artwork and/or keepsakes. I understand and agree to the following terms regarding the scope of support, communication, responsibilities, limitations, and fees

      Reservation of Services

      Encapsulation contracts are reserved on the Agency calendar beginning at 37 weeks of pregnancy. If delivery occurs prior to 37 weeks, the Agency will make every effort to make accommodations to pick up the placenta within the designated hours or send a back up courier if possible. However, support availability may be subject to existing commitments during that time.


      At 37 weeks gestation a small cooler will be provided to me with instructions. This cooler & its contents (2 icepacks & 2 gallon size ziploc bags) should be taken to the hospital. My placenta should get double bagged & refrigerated or in the cooler within 4 hours of placenta delivery.

      If I contract for Placenta Services 37 wks gestation or after, the responsibility to provide a cooler may fall on myself, the client if a cooler is not available to me by the Agency. 

      Once my placenta has been picked up for processing, no refunds will be given under any circumstances.

      If my provider determines my placenta needs to be biopsied, I will ask if they will take a piece from the placenta instead of the entire placenta.

      If the placenta leaves my possession for any reason, it can not be processed for ingestion.

      If myself or my baby develop a fever during deliver or within 24 hrs of delivery, it is deemed unsafe for consumption.

      Alternative Placental Traditions or products will be recommended for the placenta if it is not recommended for consumption.

      Communication

      When my labor begins, I will notify the Agency by text: 864-712-5712

      Once I deliver the placenta, myself or a designated person on my behalf will text 864-712-5712 with clients name & address for pickup.

      My placenta will picked be up from my birthing location withing 36 hours, between the hours of 8am-6pm. 

      If my birthing location will not allow the placenta to stay on their premises until pickup hours, I will text and/or call the agency for immediate pick up.

      Agency Numbers:

      864-712-5712 or 864-518-9521 or 864-556-7045

      (Provide clients name & address for pickup.)

      Backup Support

      If my placenta encapulator is unable to pick-up and/or complete the processing of my placenta within the agreed upon time-frame due to, but not limited to illness, called to a birth, unforeseen "Acts of God" such as impassable road conditions, fallen trees, etc., no refund shall be issued. I understand that full payment for contracted services is still required but there will be no additional cost to me for any extra expenses incurred.

      The Agency may at their discretion:

      • Instruct me to freeze the placenta
      • Agency will freeze the placenta
      • Contact a courier to pick up placenta
      • Assign a backup encapsulator

      Normal Turn Around Time

      • Placenta Pickup: Within 36 hrs of placenta birth between hours of 8am-6pm
      • Capsules, Prints and Cord Keepsakes Processed: 4 days from pickup
      • Salves and tinctures: 6 wks

      Non-Medical Role

      I understand that my encapsulator is not a medical professional and does not perform clinical tasks such as medical diagnosis or treatment, or any other activity that requires a professional healthcare license. She is not responsible for the outcome of my pregnancy, labor, or postpartum experience. My encapsulator may provide information, support, and comfort. In case of a medical emergency, the encapsulator will advise the Client to seek medical attention from a healthcare provider. The encapsulator does not assume any responsibility for the health of the Client or the baby.

      I understand that my encapsulator will not make decisions on my behalf or speak directly to medical personnel in place of me or my partner. She will help us understand the information provided by the birth team, summarize options, and offer emotional support—but we are responsible for communicating directly with our care providers.

      I acknowledge and accept that my encapsulator:

      • Is not a medical professional
      • Is not a substitute for advice from a qualified doctor
      • Recommends that I consult my doctor before making any changes to my diet or exercise regime or taking any dietary supplement
      • Does not warrant the accuracy of any information provided
      • Is not liable for any losses may may suffer by relying on their advice
      • Does not recommend any particular product
      • Is not a covered entity or a business associate of a covered entity under HIPAA.

      Boundaries & Right to Withdraw

      I understand that my encapsulator may withdraw from providing services at any time if she feels uncomfortable or unsafe, with prior notice when possible. This may include issues related to behavior, environment, aggressive pets, or any factor that compromises her ability to provide safe, effective support.

      If I cancel services after the call to pickup my placenta but before the placenta is in their posession, a travel fee will be imposed equal to the appropriate travel fee for my location.

      Conditions of Service

      I understand that:

      The information and reference materials contained here are intended solely for the general information of the reader. It is not to be used for treatment purposes, but rather for discussion with the patient's own physician. The information presented here is not intended to diagnose health problems or to take the place of professional medical care.

      The information contained herein is neither intended to dictate what constitutes reasonable, appropriate or best care for any given health issue, nor is it intended to be used as a substitute for the independent judgment of a physician for any given health issue.

      All content, including text, graphics, images and information, contained on or available through this web site is for general information purposes only. The major limitation of informational resources cannot take into account the unique circumstances that define the health issues of the patient. All students of the Brilliant Birth Academy Fertility Health Coach program and associated websites agree to read and abide by the complete terms of this agreement. 

      The information provided is not intended to, cannot, and should not be expected to be a substitute for a personal consultation with your own qualified doctor. Teh agency does not accept any liability for any failure to identify any medical condition or disease; this is not the purpose of our services.

      They may provide me with information relating to products that they believe might benefit me, but such information is not to be taken as an endorsement or recommendation. Some such products may not be available without a prescription, but they do not dispense or prescribe any prescription products. The information provided is intended for educational purposes only and should not be taken as professional medical advice or used as a substitute for medical care. They are not responsible for any adverse affects or consequences that may result, either directly or indirectly, from that information.

      They will make reasonable effort to protect the privacy of your medical information that is shared with them, including any medical test results. However, that information is not protected by doctor-patient confidentiality nor is it governed by HIPAA.

      Consult your Doctor

      They are not qualified medical advisors and make no claims to be so. The information they provide should not be taken to be, and is not a substitute for, personal medical advice and instruction. I should not take any action based solely on their advice.

       I should consult my doctor:

      • For any medical interpretation of my test results
      • On any matter relating to my health and well-being
      • Before making any changes to my exercise or diet
      • Before taking any nutritional, herbal, homeopathic or hormonal supplementation
      • Before beginning any therapy

      Exclusion of Warranties

      They will provide their services to me with reasonable care and skill. But make no other warranty, express or implied, with respect to those services. All other warranties are excluded to the maximum extent permitted by law.

      They believe that the information thy provide, including that on their website, brochures, flyers and information packets, is accurate, but cannot guarantee such accuracy. They therefore make no warranty as to the accuracy of that information, and it should not be relied upon as being correct, complete or accurate. It is my responsibility to verify such matters independently from primary sources of information and by taking specific professional advice.

      Exclusion of Liability

      If I rely on, buy or use a product or therapy, I do so at my own risk. Each person is different, and the way someone reacts to a product or therapy may be significantly different from another. They cannot predict how I may react to any particular product or therapy. 

      To the maximum extent permitted by law, we exclude:

      • Any and all liability in contract, tort (including negligence), breach of statutory duty or otherwise for any direct, indirect, special, incidental, or consequential costs, losses, claims, damages, expenses or proceedings (including but not limited to loss of profits and wasted management time) incurred or suffered by arising directly or indirectly out of or in connection with their services, including but not limited to any loss, damage or expense arising from any defect, error, imperfection, fault, mistake or inaccuracy with the information or advice they provide
      • Any and all liability for injury or loss arising out of the use of, or reliance on, the laboratory results and/or the dietary, supplement and lifestyle suggestions they may provide
      • Any and all liability for injury or loss arising from any product or treatment I may choose to take
      • Any and all liability for any failure to identify any medical condition or disease.
      • I understand and agree that this is not the purpose of their services.

      This is a comprehensive limitation of liability that applies to all damages of any kind, including (without limitation) compensatory, direct, indirect or consequential damages, loss of data, income or profit, loss of or damage to property and claims of third parties.

      All material and information they may provide about products and therapies is provided solely for educational purposes and for use when discussing my health with my doctor. By providing me with such material and information, they do not necessarily endorse, recommend or promote any such product or therapy. 

      Release of Liability

      I acknowledge that April’s Doula Services and any affiliated doulas or encapsulators are not liable for any aspect of medical care received during my pregnancy, labor, birth, or postpartum period. I release them from responsibility for outcomes related to medical care provided by my healthcare providers or birth facility.

      Agreement to Terms & Conditions

      I have read and understand all terms and conditions outlined above. I understand that support is not guaranteed until availability is confirmed and the 50% non-refundable retainer has been paid. I accept full responsibility for payment of all contracted services.

      By signing below, I agree to the Terms & Conditions of Support with April’s Doula Services.

    • Ala Cart Support:  
    • Photo Consent: 
    • Please select the type of photos you are comfortable with your doula taking while in your home, at the hospital or the birthing place. By selecting, you are giving permission to use these photos for marketing and/or social media purposes at the discretion of your doula and April's Doula Services. Inanimate objects are especially useful for this purpose. Please select ALL options that you are comfortable with.*
    • Payment Options & Parking Fees: 
    • Payment Options:*
    • Parking Fees (to be paid by client):*
    • I wish to have the following doula(s) support me:*
    • Postpartum & Overnight Newborn Care Clients Only:
      I wish to purchase:
           
       
         

      We have discussed      for Day Support
      We have discussed       for Sunrise/Sunset Support
      We have discussed     for Night Support

    • Liability Release Waiver and Consent for all Support:  
    • Liability Release Waiver and Consent Form for Doula Support

      April's Doula Services, LLC, the provider of support, along with it's individual members, independent contractors, agents, and employees, shall not be held liable for any accidents, injuries, illnesses, any aspects of my, or my baby’s, medical care or treatment provided by my chosen health care professional(s) or hospital during my pregnancy, birth or postpartum. Nor shall we be held liable for any other unforeseen circumstances that may occur during the course of day or overnight doula or newborn care support.

      Client acknowledges and accepts that caring for the home and newborns involves inherent risks, and therefore releases the support person from any and all liability arising from the provision of day and overnight support. Client agrees to indemnify and hold harmless the provider from any claims, damages, or liability arising out of or related to the support provided. This non-liability clause shall survive the termination of this agreement.

      Client agrees to assume full responsibility for any parking fees, tickets, fines, or penalties incurred as a result of directing the Doula to park in a specific location or area.

      Client acknowledges that the Doula and/or Independent Contractor does not provide transportation services and will not transport the Client, infant, or family members in their personal vehicle under any circumstances, including but not limited to trips to the hospital, birthing location, store, or other destinations.

      In the event the Client requires transportation and is unable to drive themselves, the Client agrees to arrange appropriate transportation, such as through a rideshare service or other means. If the Client is unable to arrange transportation independently, the Doula may assist in coordinating a rideshare on the Client’s behalf. All costs associated with such transportation will be the sole responsibility of the Client and will be billed accordingly.

      The Doula may choose to follow behind the Client in their own vehicle to the hospital or birthing location; however, this does not constitute transportation of the Client and does not create any duty or liability related to the Client’s travel.

      The Doula is not a medical professional and does not perform clinical tasks such as medical diagnosis or treatment, or any other activity that requires a professional healthcare license. The Doula's role is to provide information, support, and comfort to the Client and their family. In case of a medical emergency, the Doula will advise the Client to seek medical attention from a healthcare provider. The Doula does not assume any responsibility for the health of the Client or the baby.

      Assumption of Risk

      The Client acknowledges that postpartum doula services involve inherent risks and agrees to assume those risks voluntarily. The Client understands that April's Doula Services, the Doula, and/or Independent Contractor provide support and information but not medical advice or services. As your doula, we follow the current safety recommendations set forth by the Centers for Disease Control and Prevention (CDC) and the American Academy of Pediatrics (AAP). Any deviation from these guidelines must be accompanied by written instructions from your licensed pediatrician. This ensures that your child's remains aligned with evidence-based medical recommendations.

      Home Surveillance Policy

      We understand and respect that many families use home surveillance systems for safety and peace of mind. While we fully support your right to monitor your home, we kindly request that you disclose the locations of all recording devices (audio and/or video) in areas where doula care will be provided.

      This allows our doulas to maintain appropriate boundaries, such as stepping out for private phone calls or changing clothes if necessary. Transparency ensures mutual respect, comfort, and professionalism in the care environment.

      Consent to Doula Services

      The Client consents to receive the services outlined above from April's Doula Service and/or it's Independent Contractors. The Client understands that April's Doula Services, the Doula, and/or Independent Contractor is not responsible for the outcome of labor, delivery or postpartum recovery and that their role is to support the Client.

      Release and Waiver of Liability

      The Client releases and holds harmless April's Doula Services, the Doula, and/or Independent Contractor from any and all liability, claims, and demands of whatever kind or nature, either in law or in equity, which arise or may hereafter arise from the postpartum doula services provided. The Client understands that this release discharges April's Doula Services, the Doula, and/or Independent Contractor from any liability or claim that the Client may have against April's Doula Services, the Doula, and/or Independent Contractor with respect to any bodily injury, personal injury, illness, death, or property damage that may result from the services provided.

      Communication, Conflict Resolution, Reassignment & Availability

      The Client agrees to communicate any concerns, dissatisfaction, or issues directly with the assigned Doula in a timely and respectful manner, with the intention of resolving the matter collaboratively. If the concern is not resolved after direct communication with the Doula, the Client agrees to promptly notify April’s Doula Services so that the agency may review the situation and assist in facilitating a resolution. If a resolution cannot be reached, the agency may, at its sole discretion, offer to assign a different Doula. Client understands that any reassignment is subject to availability and is not guaranteed. In the event that a Doula is unable to complete the scheduled contract for any reason, the agency will make reasonable efforts to provide a replacement; however, replacement is not guaranteed. If a suitable replacement is not available, the Client may elect to cancel the remaining portion of the contract. The Client acknowledges and agrees that no refunds will be issued for any unused services, and any remaining balance under the contract shall remain due and payable in full. The Client acknowledges that failure to communicate concerns as outlined above may limit the agency’s ability to address and resolve the issue in a timely manner.

      Agency Numbers 864-712-5712 or 864-518-9521 or 864-556-7045

      Acknowledgment of Understanding

      The Client has read this waiver of liability and fully understands its terms. The Client understands that they are giving up substantial rights, including their right to sue. The Client acknowledges that they are signing the agreement freely and voluntarily, and intend by their signature to be a complete and unconditional release of all liability to the greatest extent allowed by law. 

    • Date*
       / /
  • Should be Empty: