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Section 1: General Information
Section 2: Client Confidentiality & Consent
General Information
Life with Lex LLC -
Client Confidentiality & Consent Agreement
This Client Confidentiality Agreement (“Agreement”) is entered into by and between:
Life With Lex LLC, a Florida limited liability company (“Doula”); and (“Client”).
1. Purpose
The purpose of this Agreement is to protect the confidentiality of any and all information authorized and disclosed by the Client to the Doula during the course of the Doula's services, including but not limited to personal, medical, and financial information.
2. Confidential Information
I understand that Confidential Information refers to any data or information, oral or written, authorized and disclosed by the Client to the Doula, including but not limited to:
Personal information (e.g., name, address, phone number)
Medical history and records
Financial details
Family details and dynamics
Birth plans and preferences
Any other sensitive information disclosed during the course of the Doula’s services
3. Obligations of the Doula
Life with Lex LLC (Doula) agrees to:
Keep all Confidential Information private and not disclose it to any third parties without the express written consent of the Client, except as required by law.
Use the Confidential Information solely for the purpose of providing Doula services to the Client.
Take reasonable measures to protect the confidentiality of the information, including implementing security procedures and restricting access to only those employees, contractors, or agents who need to know the information to perform their duties.
4. Exceptions to Confidentiality
I understand that the obligations and restrictions in this Agreement do not apply to information that:
Was already in the Doula’s possession prior to disclosure by the Client;
Becomes publicly available through no fault of the Doula;
Is disclosed with the Client’s consent;
Is required to be disclosed by law, court order, or other legal process. In such cases, the Doula will notify the Client promptly to allow the Client to seek a protective order or other appropriate remedy.
5. Term
I, the Client, authorize that the confidentiality obligations in this Agreement shall continue indefinitely, even after the termination of the Doula’s services.
6. Governing Law
I understand that this Agreement shall be governed by and construed in accordance with the laws of the State of Florida.
7. Severability
I understand that if any provision of this Agreement is found to be invalid or unenforceable by a court of competent jurisdiction, the remaining provisions shall remain in full force and effect.
8. Entire Agreement
I understand that this Agreement constitutes the entire understanding between the parties with respect to confidentiality and supersedes all prior discussions, agreements, or understandings of any kind.
9. Amendment
I authorize that this Agreement may only be amended by a written document signed by both parties.
10. Consent
I understand that by choosing to consent below, I authorize and acknowledge that both I and Life with Lex LLC have read and understood the terms of this Agreement and agree to be bound by them.
I, (Client), authorize Life with Lex LLC (Doula), to record notes about me, including the information shared from all submitted forms and any information shared but not limited to: all contact info provided (email, telephone number, address, hospital/birth center), information regarding health history and birth experience/plans (past and present), information shared about partner/spouse, family members, friends and medical staff (OB/Midwife/Nursing Staff) as related to the baby’s health.
I understand that the information collected from these forms will not be shared with affiliated DONA Doulas within the Life with Lex LLC resource group unless I give authorization and consent (located below).
I understand that if I have any questions, I can contact Life with Lex LLC at the following email: Lex.Doula.This.Thing@gmail.com.