Advance Planning Retention Agreement

(hereafter “Client”) hereby retains Final Chapter Doula Services, LLC ( hereafter “Final Chapter”) for the purpose of advance end of life planning and the naming of a health care proxy (also known as a health care power of attorney).

Advance End of Life Planning documents are documents that set forth a Client’s choices with respect to the type and amount of interventional medical care they wish to receive in different circumstances. Examples of this include, but are not limited to, whether the Client, if subsequently diagnosed with a terminal condition, would want to be resuscitated in the event of a cardiac arrest. The amount of detail in an advance end of life planning document depends on the Client, but in general the documents reflect the Client’s philosophy as to the relative importance of duration vs. quality of life.

Final Chapter has explained to Client that there are forms available on public websites which may be used for the naming of a health care proxy and for the creation of rudimentary advance end of life planning documents.

Final Chapter has further explained to Client that the purposes of the initial consultation are: (1) to fully explore with Client the parameters to be considered in the naming of health care prox(ies); (2) to assist Client in their thoughtful consideration of future contingencies that may arise with respect to their health; the surrounding circumstances that might go into a decision concerning what medical intervention would be appropriate and/or desirable in each contingency; and the careful articulation of Client’s choices.

Nothing in this consultation should be construed as medical or legal advice. Any medical or legal questions Client has concerning these forms should be directed to their physician or attorney.

With full understanding of the foregoing, Client hereby retains Final Chapter for the purposes of Advance End of Life Planning

Fee per person without document preparation: $200 payable at time of consultation
Fee per person with document preparation: $475 payable at time of consultation