Belly Binding Service Contract

Your Name

First Name Last Name

Email

example@example.com

Cell Phone Number

Area Code Phone Number

Home Address (where I will come to bind you)

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Estimated Due Date

Date Date Picker Icon

How many days of belly binding? (all services include a plain muslin belly bind and panel)

One-time teaching session & belly binding video ($150) Three-day belly binding (includes teaching session and video) $250 Five-day belly binding (includes teaching session and video) $325

Add Optional Services (no additional cost, unless indicated)

Traditional Warming paste (spices, clay, olive oil) Custom Essential oil blend Travel fee (outside my immediate service area) - $25 Batik cotton (colorful) belly bind ($75) Additional days of binding ($35 each)

As a non-clinical support person, I (BreeAnn Moore) make no medical claims for the outcomes of my belly binding services. I cannot guarantee results.

Belly binding is most effective when the wrap is worn for 8-12 hours daily for approximately 40 days and accompanied by gentle, postpartum-appropriate exercises. Belly binding after the first six weeks postpartum may not be effective. Belly binding is also MOST effective when the client remains in bed the majority of her time wearing it. The more you move, the less effective it may be. The binding is intended to be worn as the client rests and heals in bed.

Essential oils or Traditional Warming paste may be used, but are not meant to treat or cure any medical conditions. Traditional Warming paste includes any combination of the following: black pepper, cinnamon, turmeric, ginger, clove, redmond clay, olive oil, and calendula. Only theraputic grade DoTerra Essential Oils will be used, if desired.

By signing this contract, you (the client) take full responsibility for your health and medical care. Please notify me of any unusual pain, circumstances of the recent labor/birth, applicable medical concerns, and/or allergies experienced.

I will not attempt to diagnose any symptoms discussed, but will direct the client to the appropriate medical care provider as needed.

Service provider (BreeAnn Moore) recommends all postpartum women make an appointment with their local physical therapist and/or chiropractor for pelvic floor assessment after having a baby. The client understands that belly binding is not recommended with the following conditions: severe pelvic organ prolapse (bladder, uterine, etc.), emergency hysterectomy, severe diastasis recti (abdominal separation), and abdominal hernia.

I am not a licensed massage therapist, herbalist, or aromatherapist and do not claim to practice as one. Touching is limited to contact necessary to apply essential oils or warming paste and wrap the binding around the client's abdomen. My sole purpose is to provide for the physical comfort and emotional support of the postpartum mother. Knowledge imparted during the course of the belly binding service is based on my experience as a birth doula, a mother, and as a professional postpartum belly binder. This advice should not be taken as medical advice, and any action taken/results had based on my suggestions is the client's responsibility and liability.

All services include 1 belly panel, 1 belly bind, access to my online self-binding course video, and warming paste or essential oils as desired.

**Note: your belly binding should be worn as much as possible during the first 6 weeks postpartum, or about 40 days.

**For best results, take a warm shower before binding and applying paste. Be sure to drink water and/or herbal tea frequently while wearing the bind.

Packages must be paid in full before services are provided.

Fees are final and may not be refunded unless I, BreeAnn Moore, agree to default on the contract. Services can still be provided in cases of miscarriage, stillbirth, and emergency cesarean section, with doctor or midwife's approval and after any stitches are removed.

I agree to not release your information to any third party without prior consent.

This contract is drawn up and agreed upon by the following person as designated by their signature below.

Digital Signature - type your first and last name below

First Name Last Name

digitally signed by BreeAnn Moore

Payment - may pay in person OR Venmo OR PayPal to authorbreeannmoore@gmail.com. Contact me for details or questions. Minimum due upon contract signing is $50 non-refundable deposit. Remainder due by the 36th week of pregnancy, or before service is provided for other arrangements. Please indicate your preferred payment method below.

Please indicate if you are paying full price, or if a promotion was offered. Select an option below:

You can ask me about promotions available at any time. I do not guarantee there will be promotions available, nor do I guarantee that the client will receive a refund or adjusted payment schedule if a promotion becomes available after this contract has been signed.

Contract for Postpartum Belly Binding Services