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Bereavement & Infant Loss Agreement
AthensBorn Birth Services- Bereavement & Infant Loss Services Agreement
We’re honored that you’ve chosen AthensBorn Birth Services to provide support to you during this difficult time.
AthensBorn Birth Services agrees to provide the following services:
One consultation to determine how we can best support you and what your individual needs will be.
The presence of a doula at any medical procedures required (ex: D&C or D&E) or at your birth, if desired. Some families are comforted by having their doula present; others prefer to have more privacy and ask that only a partner, friend or family member be by their side at these times. It is a personal decision and we will respect your choice.
A postpartum visit in your home within one week following your procedure or birth to help ensure that you have access to all the resources you will need for your recovery.
Client responsibilities:
Please inform us of any changes in your situation or scheduled procedures so that we can do our best to be present when you need us.
Because we believe that every individual and family experiencing loss deserves support, we offer a sliding scale fee of $0-$100. Fees received will go toward continuing education and training to better serve our families, but payment is absolutely not required. **Please do not allow your financial situation to prevent you from seeking our services.
If you agree to this offer, please respond by filling out this form below. If you have any additional questions please contact us.
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By checking the box below, I acknowledge the terms and conditions of this agreement.
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HOME
ABOUT
KIND WORDS
DOULA APPRENTICESHIPS
FAQ
BLOG
SERVICES
BIRTH DOULA PACKAGES
>
LABOR DOULA PACKAGE
APPRENTICE LABOR DOULA PACKAGE
CESAREAN BIRTH PLANNING PACKAGE
LAST MINUTE DOULA SERVICES
PLACENTA ENCAPSULATION
LACTATION SUPPORT
>
Lactation Consultations
Pregnant & Planning Ahead
Lactation Education & Classes
Lactation & Insurance
POSTPARTUM SUPPORT
GIFT CERTIFICATES
CLIENTS
Online Forms
Local Resources
FAQs
Community Connections
Insurance Reimbursement
CONTACT
EVENTS AND HAPPENINGS
Movement & Positioning Workshop
AthensBorn Shop
Shop Birth Doula Services
Shop Lactation Services
Shop Postpartum Services
Shop Placenta Services