Newborn & Postpartum Care Service Agreement
Mother’s Name: Partner’s Name:
Baby’s Name: DOB Baby:
For me:
♥ I will respect you, your family, your home and your parenting styles.
♥ I will provide non-medical, physical, emotional and informational support (including local resources) after the birth of your baby.
♥ I will help with self-care recovery, postpartum comfort measures, infant care, parenting information, and provide assistance with learning to feed and care for baby.
♥ I will NOT perform clinical tasks, or medical assessments, nor do I provide medical advice or diagnoses for mother or baby.
♥ My support services do not replace care from a medical provider.
♥ Support can include assisting with light household tasks, and other forms of support as appropriate and necessary.
♥ I do NOT perform major housecleaning tasks (ex: washing windows or yard work).
♥ I am NOT able to provide transportation for mother, baby or family.
♥ In the event of illness, emergency or severe weather, every effort will be made to reschedule services as soon as I am aware that I cannot keep our appointment.
For the Client:
♥ I will communicate my needs to the doula as her duties will depend on my priorities and particular needs that day.
♥ If I am unable to keep my appointment, I agree to give the doula at least 24 hours notice.
♥ In the event of illness, emergency or severe weather, every effort will be made to reschedule services as soon as I am aware that I cannot keep our appointment.
Service Details
♥ One free consultation in person or via phone, to discuss your needs, proposed schedule and to ensure compatibility.
♥ Baby care education and support (assist in bathing, feeding, comforting the baby, organizing the nursery/your home, etc.)
♥ Caring for baby so parents can rest
♥ Breastfeeding or bottle-feeding support
♥ Preparing simple, nutritious snacks
♥ Maintaining simple housework (laundry, vacuuming, emptying garbage, straightening up the house, dishes, etc.)
♥ Referrals to other professionals as needed
Fees, Policy, Payments
Please let me know as soon as possible after meeting, if you would like to proceed with my support! This is to hold your spot on my calendar, and ensure that you receive the days/times of support that work best for your family. My fee for postpartum doula support is $35.00 per hour. An invoice will be sent out via email, weekly or biweekly. Checks, cash and PayPal are accepted.
Mother’s Name: Partner’s Name:
Baby’s Name: DOB Baby:
For me:
♥ I will respect you, your family, your home and your parenting styles.
♥ I will provide non-medical, physical, emotional and informational support (including local resources) after the birth of your baby.
♥ I will help with self-care recovery, postpartum comfort measures, infant care, parenting information, and provide assistance with learning to feed and care for baby.
♥ I will NOT perform clinical tasks, or medical assessments, nor do I provide medical advice or diagnoses for mother or baby.
♥ My support services do not replace care from a medical provider.
♥ Support can include assisting with light household tasks, and other forms of support as appropriate and necessary.
♥ I do NOT perform major housecleaning tasks (ex: washing windows or yard work).
♥ I am NOT able to provide transportation for mother, baby or family.
♥ In the event of illness, emergency or severe weather, every effort will be made to reschedule services as soon as I am aware that I cannot keep our appointment.
For the Client:
♥ I will communicate my needs to the doula as her duties will depend on my priorities and particular needs that day.
♥ If I am unable to keep my appointment, I agree to give the doula at least 24 hours notice.
♥ In the event of illness, emergency or severe weather, every effort will be made to reschedule services as soon as I am aware that I cannot keep our appointment.
Service Details
♥ One free consultation in person or via phone, to discuss your needs, proposed schedule and to ensure compatibility.
♥ Baby care education and support (assist in bathing, feeding, comforting the baby, organizing the nursery/your home, etc.)
♥ Caring for baby so parents can rest
♥ Breastfeeding or bottle-feeding support
♥ Preparing simple, nutritious snacks
♥ Maintaining simple housework (laundry, vacuuming, emptying garbage, straightening up the house, dishes, etc.)
♥ Referrals to other professionals as needed
Fees, Policy, Payments
Please let me know as soon as possible after meeting, if you would like to proceed with my support! This is to hold your spot on my calendar, and ensure that you receive the days/times of support that work best for your family. My fee for postpartum doula support is $35.00 per hour. An invoice will be sent out via email, weekly or biweekly. Checks, cash and PayPal are accepted.
