Release from Liability
In entering into a contract for Doula (Birth Support) Services with DoLove Birth Services, and Lucretia Jones, herein referred to as the doula, on (Date)______________,
I/we hereby acknowledge that during the performance period of this contract, services may be provided to me/us in my/our home, traveling to a medical facility, hospital, and/or birthing center. I/We understand the doula has a limited role pursuant to the description of tasks outlined in the above-referenced contract wherever services are provided to me/us.
The doula has not represented to me/us that contracting for her services guarantees in any way, a risk free or emergency free labor and birth experience. I/We understand that the doula does not make medical or nursing decisions on my/our behalf, to include the decisions when to seek medical care at a hospital or birthing center when labor support services are provided in my/our home. When services are performed in my/our home or a medical facility, I/we acknowledge that the doula is not responsible for the performance of clinical tasks to include medical or nursing decisions regarding the inclusion or exclusion of treatments available to me/us and my/our baby.
Now, therefore, in consideration of the above acknowledgments, I/we (both jointly and separately) on behalf of myself, ourselves, my/our heirs, administrators, personal representatives, executors, and-assigns do RELEASE AND FOREVER DISCHARGE DoLove Birth Services, and Lucretia Jones from all damages or causes of action, either at law or in equity, which I/we may have or acquire or which, may be accrued to me/us, my/our heirs, administrators, personal representatives, executors, or assigns as a result of using the doula services of DoLove Birth Services, and Lucretia Jones. I/We intend this to be a COMPLETE RELEASE AND DISCHARGE from all liability whatsoever.
I/We have read all statements contained herein and I/We fully realize that I/We are signing a COMPLETE RELEASE AND BAR to any claim, which I/We have or believe I/We may have resulting from our contract for doula services.
(Client's Partner) ________________________________(Date)___________________
(Doula) ________________________________________ (Date)___________________