Angel Touch Doula Birth Contract
The following contract is between the clients: __________________________________
__________________________________________________________________________
and Kim Racette – Birth Doula d/b/a Angel Touch Doula.
Doula Signature Date
____________________________________ ______________________
Client Signatures
____________________________________ ______________________
____________________________________ ______________________
Payments:
Date ______________________ Amount____________________
Balance Due_________________ Date Due___________________
Please make payments payable to Kim Racette.
You can mail payment to: Kim Racette, 5304 Palo Duro Ave NE, Albuquerque, NM 87110
The following contract is between the clients: __________________________________
__________________________________________________________________________
and Kim Racette – Birth Doula d/b/a Angel Touch Doula.
- I will provide continuous emotional and physical support to Client in labor. I will provide reassurance and perspective to Client and Partner, make suggestions, help with relaxation, positioning, pain-coping, and other techniques for labor.
- I will provide 1-2 prenatal consultations in order to become acquainted and explore Client’s priorities, fears, expectations and concerns. I will also discuss Client’s preferences regarding pain medication and newborn care.
- I will be available by phone or email for questions the client might have during her pregnancy.
- I ask that the Client calls when she suspects labor may be beginning, even if she does not yet need my support, so that I can arrange things and be there when you need me. I will make every effort to arrive at the birthplace within an hour of the Client’s call to let me know that labor is progressing and they need my assistance.
- I will have in place a back-up doula in case I am unable to attend the Client’s birth due to an unforeseen emergency, or in the case of an unusually long labor.
- After the birth I will stay with the Client and family for one or two hours after the birth, until Client is comfortable and family is settled in for quiet time together. I can also help to initiate breast-feeding.
- I will provide a post-partum visit within the first few weeks after the birth.
- Services I will NOT provide:
- Will not perform clinical tasks, such as blood pressure, fetal heart checks, vaginal exams, etc.
- Will not recommend any medical advice or medical course of action. Any decisions or choices are the responsibility of the Client. I can help Client get the information necessary for them to make an informed decision.
- Will not perform clinical tasks, such as blood pressure, fetal heart checks, vaginal exams, etc.
- I will make every reasonable effort for myself or my back-up to provide services described herein. If a Doula (myself or my back-up) fail to attend Client’s birth due to my error or fault, Client will be reimbursed 70% of fees paid. If it is due to circumstances beyond anyone’s control such as: extremely rapid labor, restriction by hospital staff, failure to call me or acts of God, there will be no reimbursement of fees. Client will not be charged extra for a long labor or reimbursed for a short labor.
- I require a $300 retainer fee at time of hiring; it will be put towards the full fee of $912.16 ($850 plus tax). This retainer ensures a spot for you on my calendar for your due date. The balance of the fee needs to be paid 3 weeks prior to your due date.
Doula Signature Date
____________________________________ ______________________
Client Signatures
____________________________________ ______________________
____________________________________ ______________________
Payments:
Date ______________________ Amount____________________
Balance Due_________________ Date Due___________________
Please make payments payable to Kim Racette.
You can mail payment to: Kim Racette, 5304 Palo Duro Ave NE, Albuquerque, NM 87110