Timeless Voices USA
Time-Less Voices, LLC – Death Doula Consent Agreement @www.timelessvoicesusa.com
This Consent Contractual Agreement ("Agreement") is made and entered into on
, by and between:
Name: Address: Contact Information:
1. Purpose:
This Agreement outlines the terms and conditions under which the Consultant/Death Doula Specialist will provide services to the Client as a [Death Doula / End-of-Life Care Provider].
2. Services Provided:
To provide the following services to the Client: Emotional support and counseling related to end-of-life concerns.
Assistance with advance care planning, including but not limited to healthcare directives and funeral arrangements.
Practical support includes coordinating with healthcare providers and assisting with daily living activities.
Education and resources regarding death and its processes.
Consultant Services/Death Doula Specialist: Providing guidance and support regarding end-of-life planning and decision-making. Direct Care: Offering compassionate care and assistance to clients nearing the end of life.
Legacy Work: Assisting clients in documenting and preserving their life stories and legacies.
Advance Care Planning involves facilitating discussions and documentation of medical wishes and preferences. Companion Support involves providing companionship and emotional support to clients and their families.
Flexible Availability: Being available to clients based on their needs and schedules.
Companionship and Emotional Support: Offering emotional support during the end-of-life journey.
3. Client's Rights and Responsibilities:
The Client retains the following rights: The right to make decisions regarding their care and treatment to the extent law permits. The right to privacy and confidentiality of their personal information. The right to revoke or modify this Agreement at any time, with proper notice to the Consultant and Death Doula Specialist.
4. The Client agrees to:
Provide accurate and complete information about their preferences, wishes, and medical history. Communicate openly and honestly with the Consultant/Caretaker regarding their needs and concerns. Respect the Caretaker's professional boundaries and expertise.
5. Consultant/Caretaker's Responsibilities:
The Caretaker agrees to: Provide compassionate and competent care by industry standards and ethical guidelines. Maintain confidentiality of the Client's information, except as required by law or with the Client's consent. Respect the Client's autonomy and right to make decisions about their care.
6. Compensation:
The parties agree that the compensation for services rendered shall be [Specify Compensation Details, e.g., hourly rate, flat fee, etc.]. Payment shall be made [Specify Payment Schedule, e.g., weekly, monthly, etc.].
7. Termination of Agreement:
Either party may terminate this Agreement with [Specify Notice Period, e.g., 30 days] written notice to the other party. Termination shall not relieve either party of any obligations incurred before the termination date. Final Page: Time Less Voices, LLC Death Doula Consent Contractual Agreement
8. Disclaimer:
This Agreement acknowledges that the Consultant, who operates as a Death Doula Specialist, will provide compassionate and professional services. However, the Consultant/Caretaker is not a licensed medical professional and does not provide medical advice or treatment. Clients should consult licensed healthcare professionals for medical concerns. Time-Less Voices, LLC, and the Consultant are not liable for any decisions the Client makes regarding medical care or other matters outside the scope of Death Doula services.
9. Legal Compliance:
This Agreement shall be governed by and construed in accordance with the laws of [State/Country]. Any disputes arising under this Agreement shall be resolved through mediation or arbitration, as mutually agreed upon by the parties.
10. Signatures By
signing below, the parties acknowledge that they have read and understood the terms of this Agreement and agree to be bound by its provisions.
Client Signature:Date:
Consultant Signature: Date:
11. Notary Signature:
The parties acknowledge that this Agreement may be notarized upon request to validate its legality and authenticity further. [Space for Notary Public's Signature, Stamp, and Seal] Notary Public Signature:
Date:
[Notary Public Name and Commission Expiry Date]
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