Client rights and responsibilities:
 
By reading this and filling out the information below, you agree to the rights and responsibilities.

● I take full responsibility to make an informed decision to have my placenta prepared for ingestion.
● I agree to notify Naturally Placenta as soon as I deliver in order to coordinate pick up.
● I am consenting to release my placenta to and contracting with Naturally Placenta to prepare my placenta according to OSHA and Georgia Food Safety and Handling Standards. 


● I agree to have the placenta stored on ice, in a cooler or refrigerator within 3 hours after birth and put in the freezer at 48 hours if there will be more than 2 days from birth until my placenta is handed to the encapsulator. I understand that if I fail to do this, Naturally Placenta is not responsible for the freshness of the placenta.


● I agree to notify my doctor or midwife of my wishes to keep my placenta. You may have to sign a release form if birthing at a hospital. Failing to mention this may result in the placenta being disposed of quickly by healthcare staff.
● I understand that my placenta will be handled and processed by a trained and educated encapsulator. This is not approved by the FDA and I will be consuming this at my own risk.


● I understand that it is my responsibility to supply documentation for any transferrable blood-borne pathogens, or infectious disease and I will notify Naturally Placenta in advance. I understand Naturally Placenta may inquire about my health status.

● I understand that Naturally Placenta will not be able to process my placenta in the event that there is a concern of intrapartum uterine infection or diagnosis of intrapartum uterine infection. In this situation, Naturally Placenta retains the non-refundable deposit.


● I understand that I will receive my placenta capsules within one week, usually 48-72 hours, from the time Naturally Placenta receives my placenta, or within an agreed timeframe that is discussed between Naturally Placenta and client.

Placenta specialist rights and responsibilities:
● We do not promise or guarantee specific benefits. Benefits have been backed by anecdotal and evidence based research, they are not backed by the FDA.
● We are not a medical professionals and will not diagnose or treat any health condition. We have been trained in the proper safe storing, handling and preparation of your placenta.
● In the unlikely event of an unforeseen circumstance where Naturally Placenta cannot fulfill our contract, we will find a replacement encapsulator or refund your deposit.
● We guarantee that we handle your placenta with respect and care and that you are getting your placenta back in the form that you have requested.

Fees, Deposits, Payments and Refunds
● Naturally Placenta’s fee for placenta encapsulation varies by package. A non refundable deposit of $50 is due to hold your spot on our calendar. The balance of is due upon delivery of your encapsulated placenta.

● In the event client does not like the product, there will be no refunds.

I have read and understand this contract in full.
I understand that upon receiving my encapsulated placenta, Naturally Placenta is no longer liable, including and not limited to any other person(s) ingesting my encapsulated placenta.

Please Indicate Encapsulation Benefits Package Chosen Below.

 

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