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new Client

So, we’ve had a consultation and you’re ready to make this thing official and hire me. I am thrilled!

In order to secure me as your birth doula for your baby’s estimated date of arrival (due date), you’ll need to sign my contract and put down a deposit. If you are interested in a payment plan, those options can be found below along with my contract, which you can digitally sign right from this page.

In addition to that, if you could please fill out these two forms for me, that would be awesome!

Intake Form
Medical History Form

Once all that is done, we will schedule two prenatal meetings between weeks 30-34. They can be held in your home or somewhere local like a library. This handy pregnancy calculator can help you figure out those dates, just pop in your due date and let it do the rest!
 
I will also send you a digital version of my birth binder via email and drop off a hard copy of it prior to our first meeting.
 
It’s also important to be aware of my refund policy prior to booking me, download the pdf below and save it for your records. All of this information can be found in my contract as well but the pdf is an easier read.
 
 
If you have any questions or concerns regarding any of the above, please let me know. I am here to help in whatever way I can!

Birth Doula Package Payment Plans

The total cost of this package is $1500. All services must be paid in full by 36 weeks gestation.

Option 1

Deposit (retainer fee)

Pay In Full

$375.00

$1,125

Option 2

Deposit (retainer fee)

4 Installments of

$375.00

$281.25

    Doula Contract for The Birth Doula Package

    Lavender & Mint Maternal Support Services 2025
    Direct Line: (315) 856-0412
    Email: Jodi@lavendermintdoula.com

    New York State Licensed Massage Therapist (LMT): 031963
    Name: Guererri, Jodi Lynn
    Address: Geneva, NY
    Date of Licensure: October 16, 2019

    AMTA Insurance Member ID: 1654967
    Chapter: New York
    Member Since: Jun 15, 2018
    Membership Type: Professional Active

    Terms Of Service

    As your Doula

    • I accompany women/families in labor to facilitate a safe and satisfying birth experience.
    • I provide emotional support, physical comfort, and education to help you communicate with your healthcare provider to ensure you have the information needed to make informed decisions in labor.
    • I can provide reassurance and perspective to you and your partner, make suggestions for labor progress, and help with relaxation, massage, positioning, and other techniques for comfort.
    • I can be a constant for a birthing mother in a time of ever-changing hospital shifts and alternating provider schedules.
    • I work for you, not your healthcare provider or hospital.

    As your Doula, I will NOT

    • Perform clinical tasks, such as blood pressure, fetal assessments, vaginal exams, etc.
    • Make decisions for you. Instead, I will help you get the information necessary to make an informed decision.
    • Speak to the staff on your behalf regarding matters where healthcare decisions are being made. I will, however, discuss your concerns with you and suggest options, but you or your partner will speak directly to the clinical staff.
    • Transport clients, in my vehicle, no matter the circumstance.
    • Replace your spouse/birth partner(s), rather work with them.

    Prenatal Meetings

    I will meet with you and your partner two times starting at approximately 30-32 weeks into your pregnancy. These meetings will be approximately 2 hours and will cover issues such as:
    • Discussion of, or assistance in creating your birth plan
    • Your knowledge of the birth process
    • Your feelings about pain medications
    • Pain management techniques
    • Labor and birth positions
    • Breathing
    • Ideal labor, birth environment, and experience
    • Breastfeeding
    • Mom care
    • Baby care

    Late Pregnancy

    • Once I enter the on-call period (38-42 weeks), I encourage clients to check in every few days to advise me how they are doing either via phone or email.
    • During the on-call period, I am committed to being within 50 miles of Geneva, NY at all times unless previously discussed with you.
    • In the event that I must turn off my phone, I will try to give you advance notice and will check my voicemail at least every 2 hours.

    When you think you are in Labor

    • Call me as soon as you believe you may be in labor, no matter what time it is, even if you do not feel like you need support at that time. I can answer questions, help you decipher what is going on, or make suggestions over the phone.
    • In the rare event that I do not answer your call, keep calling until I answer. Do NOT text me if you believe you are in labor.
    • I am available for your birth 24 hours a day, 7 days a week.
    • I may need up to ninety minutes to two hours to get to you from the time you request my presence.
    • You decide when and where we should meet (at your home or the hospital).
    • Except for extraordinary circumstances, I will remain with you throughout your labor and birth.
    • In the event that there is a false alarm and I have been called to the hospital, there will be a charge of $50 (due at the time of occurrence). This can usually be avoided with phone contact or a visit to your doctor's office or a call to triage.

    During your Labor and Delivery

    • I will provide continual physical, emotional, & informational support during labor and birth.
    • I will be with you from the onset of active labor until 1-2 hours after the birth. I may require short, infrequent breaks if the labor is longer than 4 hours, but at no time will I leave you alone without at least one member of your support team.

    After the Birth

    • I will remain with you for one to two hours after birth until you are comfortable and ready for quiet time with your family.
    • I will be on-call for you for 30 days after the birth for any baby care, mom care, or minor breastfeeding questions. Please contact me if you are in need.

    Postpartum Visit

    Within the first two weeks after the birth we will meet to:
    • See how you are physically recovering
    • Provide feeding support, if needed
    • Review the birth
    • Answer any baby/mom care questions
    • Admire your baby(ies)

    Surgical Birth

    • Scheduling a surgical birth does not nullify this contract.
    • In the case of a scheduled surgical birth, that is medically indicated and where I cannot be present in the Operating Room, immediate lactation and family support are offered for up to 90 minutes.
    • In the case of a medically indicated surgical birth, a 3rd prenatal meeting will be scheduled for preparation & planning for the upcoming birth.

    Failure to Provide Services

    • Full fees will apply if you fail to call me to attend your labor or you do not give me enough notice to make your delivery. If this is the case, please inform me of the birth so I may provide appropriate postpartum care.
    • If I miss your birth due to circumstances beyond anyone’s control or if I am unable to properly support you during your labor for reasons such as but not limited to an extremely rapid labor, weather conditions, or sickness, full payment for my services will be required. I reserve the right to be relieved by a backup doula for the reasons above or if support is needed for more than 24 hours.
    • I am not responsible for providing a backup doula but can provide contact information for several.
    • If I am unable to attend your labor, I will attempt to provide virtual support via video chat.

    Unexpected outcomes

    Pregnancy and birth on rare occasions include unfortunate outcomes such as stillbirth or miscarriage. Doulas are trained to help parents through these situations and it is part of your doula care. I strongly encourage you to contact me to help you through any unexpected outcome. A doula can provide reassurance and resources to assist you through these difficult times. If you have booked me before 14 weeks of pregnancy and you have a miscarriage, I will provide a full refund if no prenatal visits have taken place. After 14 weeks, I will provide bereavement support.

    A bereavement doula is a doula who walks with, supports, and helps families who are experiencing the loss of their baby, whether that loss is through miscarriage, stillbirth, or a diagnosis that means the baby will not live long after being delivered.

    Disclosure of Communicable Diseases

    You agree to disclose any communicable diseases that you have so that your doula can take appropriate precautions.

    Waiver of Liability

    As the express condition of my performance of services under this agreement, you agree, on your own behalf and on behalf of all persons or entities you may bind under New York law, to waive and hereby do waive any rights, claims or causes of action that you may have against your doula now and in the future with respect to your pregnancy, birth, postpartum period or the services your doula may provide and/or fail to provide to you. You expressly understand that, as a doula, I am not medical professionals and therefore cannot and will not provide you with medical care or advice.

    Responding to Subpoenas and Other Requests for Information

    If your doula is required to respond to a subpoena of her records relating to services your doula performed for you, or to testify by deposition or otherwise concerning such services, you agree to reimburse the doula for her time and all expenses incurred in responding to any such demand, including, but not limited to, loss of earnings, appearing at depositions or hearings, or retaining an attorney.

    Fees

    The fees for the services described above are $1500.00. A retainer fee of $375 is due, along with a signed copy of this letter of agreement to reserve my services for two weeks before and two weeks after your due date. The remaining balance is due at least four weeks prior to your due date. These fees are not refundable and a Refund Policy may be found here (https://www.lavendermintdoula.com/wp-content/uploads/2023/09/Cancellation-and-Refunds-for-Birth-Doula-Services.pdf). If your doula is not called to attend or given adequate notice to attend, your doula will not provide a refund. This includes a precipitous labor. If the fee has not been paid in full four weeks before your due date, your doula is not obligated to be present at the birth.

    • Payments can be made via cash or check. Checks can be made out to Jodi Guererri.

    I/We have read this letter describing the Labor Support Practitioner services provided by Jodi Guererri and agree that it reflects the discussion we had with our LSP.

    ATTESTATION: I agree, and it is my intent, to sign this document and affirmation by clicking the box marked "I AGREE", and by electronically submitting this document to the Jodi Guererri LMT at Lavender & Mint Maternal Support Services. I understand that my signing and submitting this document in this fashion is the legal equivalent of having placed my handwritten signature on the submitted document and this affirmation. I understand and agree that by electronically signing and submitting this document in this fashion I am attesting to the truth of the information contained therein.*
    I AgreeI Do Not Agree

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    Ready to schedule your free consultation?

    Jodi Guererri LMT

    BASED IN GENEVA, NY

    jodi@lavendermintdoula.com

    SERVICING THE FINGER LAKES & ROCHESTER AREAS OF NEW YORK.

    © Copyright 2020 Lavender & Mint Maternal Support Services | All rights reserved