An agreement for doula/birth support services covering scope of non-medical support, on-call availability, and a clear medical-care boundary.
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这是一份通用免费模板，正文为英文，不构成法律意见。请填写占位内容，并建议在正式使用前请律师审阅。
This Doula & Birth Support Services Agreement ("Agreement") is entered into as of [Effective Date] between [Doula Name] ("Doula") and [Client Name] ("Client"), with an estimated due date of [Due Date].
Doula will provide non-medical support including: [Services — e.g. prenatal visits, on-call labor support, postpartum visits], as described in [Attachment].
Doula does not provide medical care, clinical diagnoses, or medical advice, and is not a substitute for a physician, midwife, or other licensed medical provider. All medical decisions remain with Client and their medical team.
Doula will be on-call from [Number] weeks before the due date through delivery. If Doula is unavailable, backup support will be provided by: [Backup Doula Name/Arrangement].
Client agrees to pay a total fee of [Amount], with a deposit of [Amount] due upon signing and the balance due by [Date/Timing].
If Client cancels before the on-call period begins, [Refund Policy]. Fees are non-refundable once the on-call period begins, given Doula has reserved availability.
Doula agrees to keep Client’s health and personal information confidential.
This Agreement is governed by the laws of the State of [State / Jurisdiction].
Doula Signature: _______________________ Date: _______________
Client Signature: _______________________ Date: _______________