Postpartum Doula Agreement
I prefer to meet with you and your partner before you make any final decision about retaining services. This meeting does not obligate you in any way. Provided you do retain my services I will want to meet with you approximately four weeks before your due date to discuss your preferences. During this planning meeting, I will inform you of times when I may be unavailable. To cover those times, I may arrange or refer you to one or more back-up doulas. You have the right to interview each doula before she provides services for you.
My Service: I will be glad to teach you infant massage, bathing, feeding, comfort measures, safety issues and swaddling. I do not take over the care of the baby, but assist you in learning to care for your baby�s needs except during naps. This is a time to help you adjust to your new role. I will also be glad to do some light housework or cooking. This will consist of laundry (gathering, washing, drying, folding, putting away) and picking up objects off of the floor. I may sweep floors, spot mop in areas and dust. I may cook meals that are requested, provided client can supply written or verbal instructions on the preparation of the food. I may do some light cleaning of the kitchen including washing, drying and putting away dishes.
Your doula will be available for at least 5 hours a day (with a 3 hour minimum per day) beginning at your discharge from the hospital. (For special consideration, there may be times when a doula is needed for a longer shift or a second doula is also hired for overlapping shifts when needed.) Your doula needs 48 hours notice before the first day of service. There is a minimum of 10 hours for doula service. The fee is $20/hr for singletons, $30/hr twins, $40/hr triplets. There is a deposit equal to half of the minimum 10 hours service due at the time of the planning meeting. ($100). This fee is a non-refundable retainer applied to your first 10 hours of service. Doula services will be paid for at the end of each week. For billing purposes, an hour is considered to begin when I arrive at your home at a previously arranged time. If I run errands for you on my way to your home, the hour begins upon arrival at the first stop. Additional hours will be subject to availability and mutual agreement. If I arrive at your home to provide doula services as scheduled but am not needed for some reason, I will be paid in full for the time previously agreed upon. Services must be cancelled 48 hours in advance. Upon being canceled for a second time I may choose to terminate further services.
Limitations of Doula Practice: Doulas do not diagnose medical conditions in the mother or the baby but will refer you to a health care provider when appropriate. I am not a liscened lactation consultants but have breastfed my own children and do have some breastfeeding training. I will refer you to a lactation consultant or breastfeeding counselor as appropriate. Doulas do not do heavy housecleaning such as mopping, cleaning bathtubs, or yard work. Doulas do not advance you money for groceries/errands but ask for cash to make purchases on your behalf. Receipts will be provided for all purchases. We have read and agree to the provisions of this contract.
I wish to contract for services at ________ per hour, _________ hours per day for ___________ days/weeks. My due date is______________ (It is understood that services may start well before or after that date.) Agreed and accepted this ______day of ___________200___.
Client_______________________________________
Client�s Partner ______________________________
Doula_______________________________________ |
