Labor Agreement
Please review the labor doula agreement before submitting your payment.
https://drive.google.com/open?id=1nowwtDigBgsDLenEWrdyO3mkM7_jl7vt

Payments can be submitted at http://alaboroflove.org/payments-registration/

Completion of this form will act as a signed agreement. Thanks!

Submitting this form along with your retainer completes the order. Thanks!
Labor Doula Selected *
Your answer
Due Date *
Your answer
Your name and partner's name *
Your answer
Address- include city and zipcode please *
Your answer
Location for birth and provider name- doctor or midwife group
Your answer
email *
Your answer
phone numbers *
Your answer
Your final payment is due at the beginning of week 38, what date is that? *
Your answer
Retainers are $260 and non refundable, what will your balance be? *
Your answer
Are you interested in having an additional doula, an apprentice join you for free along with your primary doula? *
Do you have a preference regarding back up? There are no guarantees but we do try to honor this if possible.
Your answer
Today's Date *
Your answer
Please print your name as an electronic signature *
Your answer
How did you hear about us? *
Your answer
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