Labor Doula Agreement

Doula's Name

Parent(s) Names

Due Date

Birth Location

Home address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number

Format: (000) 000-0000.

Phone Number

Format: (000) 000-0000.

E-mail

example@example.com

Indicate the doula you wish to hire:

Please click each box, indicating agreement to the following terms of the doula agreement: Services

Please agree to the following terms of the doula agreement: Financial Agreement

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

*** A note for Venmo, Zelle, and Cash App payments: Sign and submit this agreement, then submit your payment separately through your payment app. Do not select a Product or enter your card information here. If you enter card info below, your card will be charged. ***

Balance Payments are due at the beginning of 37wks. What is that date?

Photos: All birth photos taken by the doula and apprentice belong to the client and will not be used without permission. Please initial below indicating your preference for photos taken by Labor of Love Doula & Childbirth Services, Inc. and/or your doula, for social media, marketing, and educational purposes.

Apprentice: Labor of Love has apprentice doulas who are eager for opportunities to shadow prenatal visits, client communication, and births. An apprentice can provide an extra set of hands for your doula, record birth notes, and take photos while she is also learning about birth from a more experienced doula. There is no additional cost to have an apprentice present, and she does not replace your primary doula should the need for backup arise. Please initial below indicating whether or not you are open to learning more about including an apprentice.

Signature

Input your payment information ONLY if you wish to submit your deposit using a credit or debit card. If you prefer to pay via Venmo, Zelle, or Cash App, skip the payment section and click the Submit button:

Labor Doula Services - Deposit

$515.00

Total

Debit or Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year