By Submitting this form, I agree to the following Service Agreement and Terms:

Purpose
This contract outlines the scope of care offered by doulas who are part of North Star Doula Service, LLC. It also details the agreed upon payment, number of home visits, and reasonable accommodations needed in order to provide expected services. Scope Doulas affiliated with or provided by North Star Doula Service have all successfully completed a DONA accredited Doula Certification Course and either hold or are in the active process of obtaining current certification with a major Doula Certification Institution, such as DONA, PALS, NAPS and/or the State of Oregon Registry of Traditional Health Workers (THW). Doulas offer nonmedical, evidence-based support and education prior to, during, and immediately following birth, as well as in the early postpartum period. The scope of care includes: education on physiologic labor and birth, education on common interventions, relaxation techniques, positioning and comfort techniques, an overview of medical support which may be available at your chosen birth location, education on available community resources, lactation education and planning, newborn education, emotional preparation and support, self-advocacy preparation, constant physical presence to assist with the abovementioned items for the duration of labor and birth, lactation support following birth, postpartum check-ins and birth processing. Doulas do not perform any clinical tasks (fetal heart-tone checks, abdominal exams, vaginal exams, blood pressure exams, blood draws, etc). Doulas do not advocate for a specific kind of birth and will not interfere with the advice of healthcare professionals. Doulas do not attend planned unassisted home birth. Doulas do not deliver babies. Additionally, any affiliated doulas may hold varying degrees of education, training, expertise, or certification which lend beneficial experience from which to draw in your service. These practices, such as photography, aromatherapy, massage therapy, RN, LM, CPM, CNM, or ND or MD licensures are not considered in scope of doula service, are not offered as part of this package, will not be included on the final invoice, and will not be billed separately.

Agreement:
I have hired a doula through North Star Doula Service and have agreed to receive the following services:
Two in-home prenatal visits, lasting approximately 60-90 minutes, provided to prepare me and my partner for childbirth.
24-hour email, text, and phone support throughout the course of the contract, providing reasonable turnaround time if doula is not immediately available. For example, if doula is asleep and the request is non-urgent, you may receive a response the next day.
24 hour on-call availability the week before, the week of, and the week after the estimated due date. Every effort will be made to attend a delivery outside of these dates.
Constant support during labor and delivery for a term of 24 hours which may be extended, for no additional cost, at the discretion of the attending doula, or transferred after that point to the agreed-upon backup doula until the birth is complete and immediate postpartum support has been provided as detailed below.
Immediate postpartum support until: the first successful breastfeeding has been initiated, express verbal release is given by the client, both the client and doula agree that no further care is needed immediately, or care has been successfully transferred to the backup doula in the event that the primary doula is unable to continue providing support. 

North Star Doula Service may occasionally request non-monetary support via participation in surveys, emails, text messages, phone calls, letters, petitions, and/or other methods to support the case for making doulas part of the standard of care for every family. I agree to be contacted from time to time in regards to matters such as these.

Payment:

Private party or FSA/HSA payment is due by the date of the last prenatal in-home visit prior to my birth. If insurance does not cover doula care as part of their offerings, an invoice can be made available to submit to your insurer for possible reimbursement.

Contact:

I agree to make reasonable effort (at least two phone calls with voicemails) to contact my doula when labor commences. In the event that I cannot contact my doula, I will contact my backup doula, whose number will be provided to me prior to my due date. In the event that a backup doula attends my birth, all other aspects of the agreement above will remain in force.

Refund Policy:

In the event that my birth is not attended by either my primary or backup doula, and I have made reasonable effort to make contact via at least two phone calls with voice mails left expressing my need to have service, 75 percent of the fee will be refunded and I will be released from the remainder of my contract to receive postpartum support, unless I choose to receive it, in which case I will be refunded 50 percent of the fee. If my birth takes place before or after the on-call period, every effort will be made to attend the delivery. In circumstances wherein reasonable efforts have still been made to contact the doula, but the birth is unattended by the primary or backup doula, 50 percent of the fee will be refunded and the remainder of the contract will remain intact. If I have not made reasonable effort to contact my hired doula and, as a consequence, did not receive the agreed upon labor support, no refund will be provided. Postpartum services will still be offered and may be increased in number or length, at the sole discretion of the doula. Though our doulas hold an unimpeachable record of highly satisfied clients, if a situation arises in which doula support is deemed in breach of this contract, unsatisfactory, or harmful, every effort will be made to resolve the concern, on a case-by-case basis, up to a full or partial refund at the discretion of North Star Doula Service, LLC.