We are honored you have chosen to journey with one of our trained CareDoula®'s. We are here for you to support you by providing the time you need to process what you are going through with love, respect and deep listening. We also will help you find resources during this time if that is something you want. 

BIlling Information
Full Name
email address
PHone number
street address
zip code / postal code
state / providence
Credit Card Number:
CVC Code:
Expiry Month:
Expiry Year:
I understand and agree that CareDoula® Grief Companions are a caring service of deep listening and do not offer any advice, nor take the place of any healthcare services.
I understand and agree that our CareDoula® Grief Program requires an Administrative Fee of $100. The 12 private sessions are free. 
I understand that each 12-Week Package (made up of weekly, 1-hour sessions) are private and are free. Each session is 1-hour or less (your choice) is 1 time per week, for up to 3 months (12 sessions total). It is your choice of the frequency and you and your CareDoula® will agree on a time.
I understand and agree to to alert the CareDoula® Team if I feel uncomfortable the service provided for any reason. Together we will make every effort to resolve.
I authorize Quality of Life Care, LLC to process my selected purchase for the Grief CareDoula® Program. I understand that no refunds will be processed once services begin with my Companion.
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