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.