Postpartum Care Membership Agreement

This agreement sets out the terms of a membership between the postpartum care center ("Center") and the family it serves ("Client"). It becomes effective only when BOTH parties have signed below. The Center drafts and signs first, then shares this document with the Client for review and countersignature — either in-app, or by printing, signing, and uploading a scanned copy.

Section 1 — Parties & Term

Center (name / business name):

Client — mother's full legal name:

Client — partner / co-signer name:

Client contact email:

Client contact phone:

Membership start date:

Initial term:

Section 2 — Included Care Services

The Center will make the following care services available to the Client during the term:

Any service not listed above is out of scope and handled under Section 4 (Add-On & Out-of-Scope Requests).

I have read and understood the care services included in this section.

Section 3 — Membership Fee & Payment

The reservation deposit secures the room and is credited toward the package fee. Invoices are due within 14 days of receipt. The package fee reserves capacity for the Client regardless of the exact services used during the stay.

I have read and agree to the fee and payment terms in this section.

Section 4 — Add-On & Out-of-Scope Requests

Add-on services such as extra lactation hours, acupuncture, photography, or sibling arrangements are available on request and billed separately. Any request outside Section 2 requires the Client's written approval of a quote before it is provided. The Center may decline requests that conflict with the safe care of the mother, the newborn, or other residents.

Add-on services the Client would like to pre-arrange (optional):

I understand how add-on and out-of-scope requests are approved and billed.

Section 5 — House Rules & Visitor Policy

To protect every mother and newborn, the Center maintains visiting hours, hygiene and health-screening requirements for all visitors, quiet hours, and infection-control rules including restrictions during illness outbreaks. The Client agrees to follow these rules and to ensure their visitors do the same.

I agree to the visiting hours and visitor health-screening requirements.

I agree to the hygiene and infection-control rules of the Center.

Section 6 — Health, Consent & Liability

The Client authorizes the Center to provide routine postpartum and newborn care as described in this agreement, and to seek emergency medical treatment for the mother or newborn if the Client cannot be reached in time. The Center is not a substitute for a hospital or physician and does not provide acute medical treatment. The Client agrees to disclose all relevant health information and to keep it current.

I consent to routine care and to emergency medical treatment when I cannot be reached in time.

I have disclosed all relevant health information for the mother and newborn.

Section 7 — Cancellation, Termination & Renewal

Cancellation and early check-out terms, including any non-refundable portion of the deposit and required notice period, are summarised below and apply as agreed at booking. Either party may terminate for a material breach that remains uncured 14 days after written notice. On termination, the Client pays for care provided and capacity reserved through the effective date.

Cancellation & refund terms as agreed at booking:

I have read and agree to the cancellation, termination, and renewal terms in this section.

Section 8 — General Acknowledgments

I have read and understood each section of this agreement.

I have had the opportunity to ask questions and seek independent advice.

I consent to electronic signatures having the same legal effect as handwritten signatures.

I am authorized to enter into this agreement on behalf of the family named above.

Section 9 — Signatures

Center representative — printed name:

Date:

Client — printed name:

Date:

Optional — upload a countersigned scan of this agreement:

This template is provided for reference only and does not constitute legal or medical advice. Consult qualified counsel and licensed medical professionals before relying on this document.