UNTAMED
BIRTH

I hereby acknowledge that throughout my contract period with my doula, services may be provided to me in my home, while traveling to a medical facility, hospital, birth center, or other locations. Regardless of where services are rendered, I acknowledge that my doula has a limited role in my care.

 

I understand that by contracting my doula for their services, I am not guaranteed any particular outcome nor a risk-free, emergency-free, or uncomplicated labor and/or birth experience. I understand that my doula does not make medical or care decisions on my behalf, including decisions regarding when and where to seek medical care, choices during treatment, or any other medical topic. When services are provided in the presence of trained medical staff, I acknowledge that my doula is not responsible for the performance, execution, or quality of clinical tasks, nor are they responsible for medical decisions regarding proposed treatment plans during my care.

 

On behalf of myself, my heirs, administrators, personal representatives, executors, and assigns, I agree to RELEASE AND FOREVER DISCHARGE my doula, from all damages or causes of actions, either at law or in equity, which I may have or acquire or which may accrue to me, my heirs, administrators, personal representatives, executors or assigns as a result of utilizing my doula's services. I intend this to be a COMPLETE RELEASE AND DISCHARGE them from all liability. I have read all statements contained herein and I realize that I am signing a COMPLETE RELEASE AND BAR to any claims which I have or believe I have resulting from our contract for doula services.