About this template
A Doula Letter of Agreement Form is an essential tool for formalizing the professional relationship between a birth or postpartum doula and their expectant clients. This template clearly outlines the scope of care, on-call availability, fee structures, backup doula policies, and confidentiality terms. By establishing these expectations early, both parties ensure a transparent and trusted partnership during one of life's most important milestones.
Designed for independent doulas, birth centers, and maternal care collectives, this agreement form collects all necessary client details, emergency contacts, and acknowledgment signatures in a single organized step. Using Doc2Form, you can instantly turn this document into a ready-to-share Google Form, making it effortless to onboard clients remotely and keep your records secure and accessible in Google Drive.
Clear service agreements minimize misunderstandings and protect both the practitioner and the family. With this structured template, you can present a polished, professional onboarding experience from the very first consultation.
Key features
- Outline clear scopes of prenatal, birth, and postpartum services.
- Collect client and partner details, addresses, and emergency contacts.
- Include confidentiality and terms of service acknowledgments.
- Easily convert into a Google Form with Doc2Form for instant client onboarding.
Use cases
- Independent birth doulas onboarding new expectant parents.
- Postpartum doula practices establishing service hours and fees.
- Maternal wellness collectives managing client contracts and policies.
What this form collects
- Primary Client (Birther) Full Name (Short answer)Enter your first and last name.
- Email Address (Short answer)Where we can send copies of your agreement and scheduling updates.
- Phone Number (Short answer)Primary contact number for urgent communications and on-call availability.
- Home Address (Paragraph)Include street address, city, state, and zip code.
- Partner / Support Person Full Name (Short answer)If applicable, enter the name of your partner or primary support person participating in care.
- Estimated Due Date (Date)Select your anticipated delivery date.
- Selected Doula Service Package (Dropdown)Choose the package that best fits your birth plan and support needs.
- Confidentiality and Terms Acknowledgment (Multiple choice)Please confirm that you have read, understood, and agreed to our scope of practice, backup doula policies, and confidentiality terms.
- Primary Client Signature (Short answer)Please type your full legal name as an electronic signature to confirm this agreement.
- Signing Date (Date)Select today's date.
FAQ
What is the purpose of a doula letter of agreement?
It formally defines the professional relationship, outlining the exact services provided, on-call timelines, fees, backup arrangements, and client responsibilities.
Can I customize the terms to fit my specific practice?
Yes. Once you convert this template into a Google Form, you can fully edit questions, add your specific retainer policies, or adjust package options.
How do clients sign the agreement?
You can include a text confirmation field or use Doc2Form to collect electronic acknowledgments, followed by a formal signature via PDF or separate signing tool if required.
Can I collect retainer payments through this form?
While Google Forms handles the agreement data collection, you can easily include a link to your payment gateway or invoicing platform within the form confirmation.
Get this form in your Google Drive
Save a copy to your Google Drive with one click (uses 1 credit). Or build from a PDF or description in the app.