Placenta Encapsulation Service Contract

Placenta Encapsulation Service Contract
Client Responsibilities

Placenta encapsulation services will be provided to you, by Above and Beyond Doula Care at the rate of $325. This is payable in full at the signing of this contract.
In the event of infection during labor or that you agree to have your placenta sent out for testing or it is sent without your approval, the fee of $300 will be refunded.

In the event that the Specialist determines upon examination that the placenta is not safe to consume, the fee of $200 will be refunded to the client along with a keepsake provided.

If the client decides to cancel the services after the contract is signed or if the client fails to contact the specialist within agreed upon time, NO refund fee is due.
Client is responsible for tolls and parking fees incurred by the Postpartum Placenta Specialist.
Client is to make arrangements in advance with the birth facility for release of her placenta. Contact us if you require assistance or direction with this.
Client is responsible for contacting the Specialist at the beginning of the labor and after the baby is born so doula can make arrangements for pickup. Depending on the location, the pick up fee of $50 will be added to the cost.
Postpartum Placenta Specialist will arrange pick up within 24 hours of the birth.

In the event that the Specialist is not able to provide the services in timely manner, she will provide a suitable backup.
Client will properly package and store the placenta for transport. The placenta is to be double-bagged in gallon-sized freezer bags and kept cool either in a refrigerator or on ice. If it is not possible for the placenta to be encapsulated within the first 48 hours after birth, keep the double-bagged placenta in the freezer. The placenta is to be defrosted in the refrigerator 24 hours before preparation.
Process

Your encapsulated placenta will take 2 consecutive days to prepare and the preparation will start within 48 hours of the birth.
The placenta will be cleaned, steamed and dehydrated. The dehydrated placenta will be then ground up and put into capsules. There is no guarantee as to how many capsules your placenta will yield. You can expect between 75-250 capsules. The amount of capsules varies as does the size of the placenta.
Limitations & Disclaimer

The benefits of ingesting your placenta have not been evaluated by the Food and Drug Administration. Your encapsulated placenta is intended for ingestion only by the mother that birthed it. There is no guarantee that the ingestion of your placenta capsules will yield the desired result(s). The Postpartum Placenta Specialist is not a licensed medical professional, and cannot make any diagnosis or suggest treatment. The client takes full responsibility for her health and the research and use of their encapsulated placenta.
Please Initial Each Line Below
·       I understand that no guarantee of results is either offered or implied  *

·      I understand that my Postpartum Placenta Specialist is not a medical professional and does not diagnose or treat illness.   *

·      I understand that general guidelines for placenta capsule usage are
provided for reference only and I trust in my own ability to follow my body
for actual usage decisions     *

·      I release my Postpartum Placenta Specialist from any and all liability resulting from the consumption of my placenta     *

· Equipment failure is beyond the control of the Postpartum Placenta Specialist     *
I would like to know more about your other services. Please email me.

Postpartum Preparation and/or Childbirth ClassLabor SupportBirth or Lifestyle PhotographyPostpartum Support
Have you had any of the following during this pregnancy (please check all that apply even if you have been treated, make a note in the "other" category if you have a history of the following or any that are not listed)?*

NoneGroup B Strep ( GBS+)Hepatitis A/B/CMRSAHerpes Simplex virus (HSV)Human Papillomavirus (HPV)Urinary Tract Infection (UTI)Other STD/STI (Chlamydia, Gonorrhea, HIV, etc.)Other
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My Products

Placenta Encapsulation

$325.00

Placenta Tincture

$50.00

Placenta Print made with Food Coloring

$30.00

Placenta Print made with Natural Food Coloring

$37.00

Enter coupon

Total

$0.00

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Please feel free to contact us with any questions or concerns at aabdoula@yahoo.com or call (907) 957-2782.

Dominika Buck
Above and Beyond Doula Care
13754 E Hay Wagon Way
Palmer, AK 99645
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