Birth Doula Media Release Form

Our Birth Doula Media Release Form is a professional, customizable document designed to protect both birth doulas and their clients when sharing photos, videos, or other media related to birth support. This form ensures clear, informed consent is obtained before using any media captured during pregnancy, labor, birth, or early postpartum moments. It also covers media involving support persons or minors present. By outlining transparent terms and expectations, this form helps maintain professionalism, safeguard privacy, and support ethical communication between doulas and clients.

Key Sections of the Birth Doula Media Release Form:

Client and Doula Information:
Collects essential contact information for both the doula and the client to clearly identify all individuals involved.

Purpose of Media Use:
Explains how photos, videos, or recordings may be used, including marketing materials, websites, social media, advertisements, or other media outlets.

Client Consent:
Provides a section where the client gives permission for the use of media for agreed-upon purposes, including consent for any support persons or minors who may appear.

Right to Modify and Edit Media:
Clarifies whether the doula may crop, edit, adjust, or alter the media for promotional or educational use.

Confidentiality and Privacy:
Ensures that all media is handled with care and respect, honoring client wishes regarding sensitive or private content.

Compensation or No Compensation:
States whether the client is offered compensation or is consenting to media use without payment.

Time Period of Consent:
Specifies how long the client’s consent remains valid for ongoing or future media use.

Revocation of Consent:
Explains the client’s right to withdraw consent and describes the process for requesting the removal or discontinuation of media use.

Client Acknowledgment and Signature:
Provides a section for the client to confirm their understanding and agreement with all terms in the release.

Key Features:

• Easy to Edit: Customizable to fit your birth doula practice and client needs.
• Print-Ready: Professional formatting suitable for immediate printing.
• Email-Friendly: Simple to download, complete, and share digitally.
• Clear Consent Terms: Written in client-friendly language to ensure full understanding.

How It Works:

• Purchase the Template: Gain instant access to your digital files.
• Edit the Template: Personalize the document in Microsoft Word with your business details and policies.
• Save and Use: Obtain client consent before sharing any media captured during birth support.

Please Note:

• Personal Use Only: Redistribution, resale, or forwarding is not permitted.
• Digital Product: No physical item will be mailed.
• All Sales Are Final: Digital products are non-refundable.

A well-structured media release form helps birth doulas protect client privacy, maintain clear communication, and establish trust. This template supports ethical media use and enhances professionalism throughout your birth doula practice.