Record My Placenta

Record My Placenta

by Tania at Boab Woman
Personal Details
Name*

First NameLast Name
Address*

Street Address

additional address information here

City/SuburbState

Post Code
Phone Number*

Area CodePhone Number
Email*
example@example.com
Partner's name and number (or other person I might communicate with).
Estimated date of Birth*

DayMonthYear
Or birth date.
Placenta collection & order delivery*
One pick up and delivery fee for multiple services.
Address for collection/delivery if different to above.
eg Home or RDH
Record My Placenta
When you choose to have a record of your placenta created you'll forever have the information, pictures and memories at hand.
Some families never even see their placenta. Being able to gain insights and receive a printed document can be a deeply fulfilling thing to do.

You'll receive an individualised package containing:
- A3 professionally printed documentation beautifully set out ready to be framed or displayed as you wish.
- USB containing
  - PDF version of the document for reprint at any time.
  - Any photos taken of your placenta - usually one showing where your baby grew, one with the ruler and one before a print is taken as well as any anomolies or interesting features.
Any colour preference or pregnancy story may be useful in setting out your document, feel free to share below.
After your birth please email me, Tania at BoabWoman@gmail.com with the following information if you would like it included in your document.
- Baby's Full Name
- Birth Date
- Birth time am/pm or 00hrs
- Weight
- Length
- Anything Else
Bloodborne Pathogen Declaration*

I have no bloodborne pathogens. eg. HCV, HBV, HIV etc.I have a bloodborne pathogen and will disclose below to discuss.
Details of bloodborne pathogen.
Placenta Storage Declaration*

I have read and understand the placenta storage requirements and will adhere to them if I intend on consuming my placenta. (Your cord can be collected without the placenta.)
Cost: $180

Upon submission of this from you will be emailed an invoice. Once payment is received your booking will be confirmed. Please contact Tania at Boab Woman on 0428030281, or boabbirth@gmail.com for any further questions.
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Record My Placenta

Personal Details

Record My Placenta