About this template
A Doula Service Agreement Form is an essential tool for professional birth and postpartum doulas to establish clear expectations and professional boundaries with their clients. By outlining the specific scope of services, prenatal support, birth attendance, and postpartum care, this form ensures that both the doula and the family are aligned on their roles and responsibilities before the birthing process begins.
This template is designed to simplify the administrative side of your practice. It captures vital client information, confirms the selected service package, and includes sections for legal acknowledgments and signatures. Using Doc2Form to generate this as a Google Form allows you to easily share the document via email or a link, collect responses in real-time, and maintain a secure, organized record of all your client agreements in one place.
Key features
- Define clear service packages and scope of support.
- Collect digital signatures from both birther and partner.
- Centralize client contact and emergency information.
- Easily shareable via email or website link.
- Sync responses directly to Google Sheets for easy tracking.
Use cases
- Formalizing prenatal and birth support contracts.
- Onboarding new postpartum care clients.
- Documenting service terms for insurance or reimbursement purposes.
- Securing informed consent for doula-led support.
What this form collects
- Birther Full Name (Short answer)Enter the full name of the primary client.
- Partner/Support Person Name (Short answer)Enter the name of the partner or primary support person, if applicable.
- Contact Information (Paragraph)Provide the best phone number and email address for communication.
- Selected Service Package (Multiple choice)Select the service package you have chosen.
- Terms and Conditions (Checkboxes)By checking the box below, you acknowledge that you have read and agree to the terms of service, including the scope of practice and payment policies.
- Electronic Signature (Short answer)Please type your full name as your legal signature.
- Date of Signing (Date)Select the current date.
FAQ
What is the purpose of this agreement form?
It establishes a professional contract between you and your client, clarifying the services provided, payment terms, and expectations to prevent misunderstandings.
Can I customize the services listed in this form?
Yes, once you convert this template to a Google Form, you can edit the options to match your specific service packages, such as virtual support or overnight care.
Is this form legally binding?
While this template provides a solid structure for your agreement, we recommend having your final document reviewed by a legal professional in your jurisdiction to ensure it meets local requirements.
How do I collect signatures using Google Forms?
You can use the 'Short Answer' field for typed names as a signature, or integrate a third-party add-on designed for e-signatures if you require a formal drawing-style signature.
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.