Belly Binding Contract
Please complete this form to reserve belly binding services. I will be in touch with you within 24 hours of receiving your completed form to confirm booking and discuss payment
Due Date (if applicable)
Which package would you like to purchase?
1 Day Package $150
3 Day Package $250
5 Day Package $350
As your belly binding resource, I will:
~ Provide you with a new wrap
~ Come to your home and bind you
~ Teach you how to continue binding yourself
~ Discuss a self-care plan for the newborn stage
~ Provide services within 7 days of our signed contract (if your baby has already been born)
Please initial to show that you have read and understand your belly binders responsibilities as listed above.
I ask that you:
~ Allow me up to one week to schedule your appointment after our contract is signed
~ Provide payment prior to date of services
~ Disclose any illnesses, physical complications, or concerns prior to service
Please initial to show that you have read and understand the above statement about your responsibilities.
I do not provide any medical services or advice. If you feel that you have a complication of pregnancy or birth, I advise that you contact your care provider for appropriate medical care. This service and product do not provide weight loss, waist training, or any guaranteed results.
Please type your name as your signature to complete your contract for services. Thank you!
How did you hear about Hollie's belly binding services?
Referred by a friend/ family member
Referred by midwife/ OB
Another doula referred me
Utah Doula Association
Utah Birth Forum
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