Commit.......Control......Conquer
9279 Medical Plaza Drive
North Charleston, SC 29406
ph: 8435537676
fax: 8435537747
Rebeccas


Rebecca’s Physical Therapy
Labor and Delivery
Assistance
Labor Assistant Contract
This contract is between Rebecca’s Physical Therapy, Labor Assistants,
and _______________________________,Mother, and is for $500.00, $250.00 upon signing of this contract and the balance to be paid in full by one month after the birth date of the child.
Services include 2 visits during pregnancy, assistance during labor and delivery, and 2 visits post delivery in the location of the mother’s choice. These services are intended to assist the family and include planning, problem-solving, advocacy, comfort measures, labor progression techniques, pain control and breastfeeding assistance.
Labor Assistants rotate on-call duty. The Assistant who attends your labor and delivery will be dependant upon who is on call at the time you place your initial phone call stating you believe you are in labor. You may meet with any or all of us during the meetings before and after your labor and delivery.
We will be available to you 24/7/365 unless otherwise stated in the addendum.
Thank you for inviting us into this special time for your family. We are honored to assist you. We will strive to help you not only birth your baby safely but to make you and your family feel supported and empowered during the process. We look forward to helping you create special memories you will cherish for a lifetime.
Addendum _____________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
Rebecca Stimac ______________________________________________ date _________________
Mother’s signature and date ___________________________________________________________
Copyright 2010 Rebecca's Physical Therapy. All rights reserved.
9279 Medical Plaza Drive
North Charleston, SC 29406
ph: 8435537676
fax: 8435537747
Rebeccas