If you have questions and would like more information please 

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If you are ready to move forward with Placenta Services please be prepared to complete & submit this Order Form, confirm your order details with Lauren over text, and make payment in full.

By doing this you will secure your place on Lauren's Placenta Calendar 

Below is a list of Medical Conditions that could affect Placenta Encapsulation. In some cases, we simply need to adjust the method used when processing the Placenta.  In other cases, we need to adjust dosage instructions.  And in rare cases, Placenta Encapsulation is not a safe option.  You and your baby's medical information will always be kept confidential.

Let Lauren know as soon as possible if you have any of the following Medical Conditions at any time during pregnancy:

• Gestational Diabetes (or Type 1 or 2 Diabetes)
• GBS (Group B Streptococcus)
• PUPPS
• Cholestasis
• Any STIs (sexually transmitted infections) including, but not limited to, HIV or Hep B or C
• Any high-blood pressure conditions like pregnancy-induced Hypertension or Toxemia, Preeclampsia, Eclampsia, or HELLP Syndrome

Let Lauren know as soon as possible if your baby has any of the following genetic disorders:

• Sickle Cell
• Tay-Sachs
• Thalassemia

On the next slide you will customize the preparation method used to make your placenta capsules/powder. There are 2 prep methods: Raw or Gentle

Raw

This prep-method renders a more iron-rich product and higher capsule yield. Clients report feeling a boost of energy when taking these capsules. This Prep Method is also more beneficial for postpartum anemia. Do not start taking your Raw capsules until after your milk has come in. 

NOT ecommended for anyone with:

1. A history of anxiety, insomnia, or caffeine sensitivity
2. Pregnancy-induced hypertension (high blood pressure)
3. Pregnancy-induced toxemia
4. Preeclampsia
5. Eclampsia
6. HELLP syndrome

Gentle

This prep-method renders a slightly lower capsule yield but offers some nice healing benefits. Recommended for anyone with:

1. A history of anxiety, insomnia, or caffeine sensitivity
2. Pregnancy-induced hypertension (high blood pressure)
3. Pregnancy-induced toxemia
4. Preeclampsia
5. Eclampsia
6. HELLP syndrome

Half & Half

Enjoy the benefits of both types of prep! As long as Raw prep is safe for you! Raw prep capsules or powder is ideal for your Morning dose, and Gentle prep capsules or powder is ideal for your Afternoon dose! 

Payment Policy

1. Payment, in full, is required upon completion of this Form
2. Once this Form is recieved, Lauren will confirm your Order and then send a Payment Request.
3. Once payment is made, in full, your place on Lauren's Placenta Calendar is secured.
4. Forms of payment accepted include: PayPal or Venmo
5. See 'Refund Policy' on following slides for refund details

Financial Hardship Discount Policy

1. If you currently recieve SNAP or TANF services through the state you qualify for the financial hardship discount.
2. Enter coupon code "SNAP" or "TANF" during Checkout at the end of this Form.
3. Proof is required. Text Lauren a pic of your most recent SNAP or TANF 'Benefits Letter' from TX Health & Human Services to provide your proof of eligability.
4. Pick-up of the placenta and drop-off of products is NOT offered with this discount.  You will need to arrange to have a close friend or family member drive to Cedar Creek (78612) to drop off the placenta and pick up your products.
5. If you qualify for the discount but have nobody who can drop off the placenta or pick up your products then a discounted travel fee of $25 will be added to your total. This only applies if you live and will be delivering within 60 miles of 78612 (Cedar Creek).
6. Or you may choose to have your placenta shipped overnight to me and have your products shipped back to you.  Keep in mind that you will be responsible for all shipping costs. This option is ideal for those who live farther away and in rural areas of TX. 
7. Discount does NOT apply to our 'Bundle & Save Package' or any 'Add-Ons'.
8. Discount applies to our 'Basic Service Options' as follows:

• Placenta Capsules $200
• Placenta Powder $175 (ideal for those who cannot tolerate swallowing pills)
• Placenta Smoothie Pieces $150 (ideal for those who love having daily smoothies)

Refund Policy

1. After the placenta has been picked up & processed, no refund can be issued for any reason.
2. A full refund is only issued if the placenta is determined "unsafe for consumption" (by Lauren) for reasons beyond the Client's control (see Safety Policy) and if Lauren has not yet traveled to pick up the placenta.
3. A full refund, minus $50 (for time and/or travel) will be issued for all other reasons, including:

• Client changed their mind about moving forward with Encapsulation services
• The placenta was determined "unsafe for consumption" for reasons within the Client's control (see Safety Policy)
• Lauren has already traveled to pick-up the placenta

Safety Policy

• It is important to understand the main reasons a placenta could be determined “unsafe for consumption” and avoid anything that is within your control.
• Notify Lauren before she travels to pick up your placenta if any of the following happen:

Reasons a placenta could be determined “unsafe for consumption” that are beyond Client’s control:

1. Maternal fever of 100.4 or above (which is typically indicative of an infection)
2. The placenta having come into contact with high amounts of fecal matter during delivery (determined by your OB)
3. Certain conditions or active infections that were unknown to the Client before time of birth

Reasons a placenta could be determined “unsafe for consumption” that are within Client’s control:

1. The placenta being left out at room temp for longer than 4hrs
2. The placenta being taken to Pathology
3. The placenta being handled without gloves
4. The placenta being rinsed, washed, or coming into contact with any substance or chemical
5. The placenta being refrigerated for more than 4 days without being frozen

Travel & Timing Policies

• Lauren charges no travel fee for Clients giving birth and living within a 60-mile radius of Cedar Creek, TX (78612) 

• For Clients outside of my 60-mile radius there are 3 options:
• 1) Pay a Travel Fee: It's $0.60 for every mile over 60 to pick-up the Placenta and return Home, and to drop-off your Products and return Home. 
• 2) Meet in the Middle (this option is FREE): Have a close friend or family member meet me for the Placenta hand-off and again for the Product delivery.  I can drive up to 60 miles in your direction and your Person can make up the difference. This is our most popular option!
• 3) Shipping (ideal for those too far for driving): You can choose to ship your frozen Placenta to me and then have your Products shipped back to you. Exact shipping costs vary depending on location and size/weight of packages.

• Placenta pick-ups & Product deliveries are made every day of the week as follows: Sunday (9am-4pm), Monday-Friday (7:30am-4pm), Saturday (9am-8pm). Hours may differ on Holidays. If you give birth during Lauren's "off" hours" simply keep the placenta in the cooler with fresh ice underneath and on top, so that is safely sandwhiched in between ice.
• Please have a designated "Placenta Person" who will be in charge of making sure the Placenta remains safely on ice in a cooler with you until it can be picked up.  This person will also be in contact with Lauren to let her know of any medical conditions or concerns that might have occured during labor/delivery and to let her know when she can come to pick up the Placenta.  
• When Lauren arrives to pick up the Placenta, she will be in contact with your designated "Placenta Person" who will bring the cooler out front to where she will be waiting to take it off their hands.  This allows for a qucik pick-up process that doesn't interrupt Mommy/Baby bonding!
• Turn-around time, from Placenta pick-up to Placenta product drop-off, is typically 48-72hrs.  However, Lauren's schedule on any given day will ultimately determine how quickly she can pick up your placenta or deliver your products. 

Communication Policy

1. Communication is essential to success; and knowledge is power, so never hesitate to reach out to Lauren at any time with questions, concerns, and requests.
2. Notify Lauren when you are in labor and have your "Placenta Person" let her know when the placenta is ready for pick-up. 
3. Lauren makes every attempt to pick up the Placenta as quickly as possible , and always keeps in communication with the"Placenta Person".
4. Notify Lauren of any and all medical conditions that arise at any time during pregnancy, labor, or delivery.

Release of Liability

1. Lauren Taylor has been double-trained & certified in Placenta Encapsulation Services and is up-to-date on her ServSafe Food Handling and Bloodborne Pathogens Safety certifications.
2. Lauren Taylor is not a Medical Professional.
3. Client agrees to informed consent regarding consumption and use of her placenta products.
4. Client agrees to follow any & all safety guidelines regarding the consumption, use, and storage of her placenta products.
5. Client understands and agrees to abide by the Policies outlined previously.
6. Client understands the limitations, warnings, & risks associated with Placenta consumption.
7. Client understands that Placenta consumption is not associated with "medical treatment" of any kind and to always consult with their Physician for any medical questions or concerns.
   
8. Client agrees that Tree of Life is not liable for any accidental damage to the Placenta and/or Placenata Products that is beyond Lauren Taylor's control (Examples include, but are not limited to: power outage while the Placenta is dehydrating OR a catastrophic auto accident while transporting the Placenta or finished Products)
9. Client agrees that Lauren Taylor will not be held liable for any reason.