PLACENTA ENCAPSULATION CONTRACT
Placenta encapsulation is the act of taking a fresh, raw placenta, rinsing the placenta, steaming or slicing the placenta raw, dehydrating, grinding and putting the placenta powder into consumable capsules. All processes are done with respect and education of that placenta and in a sanitary environment.
Doulas of Orlando and Orlando Placenta's specialists adhere to strict OSHA guidelines and follows proper food safety standards. The placenta capsules that are being prepared are for your (owner of the placenta) consumption only and are not designed to reverse medical conditions or ailments from pregnancy, to treat postpartum depression, to ensure normal milk supply or to replace medical attention.
Doulas of Orlando and Orlando Placenta and their specialists are not a licensed medical professional such as a care provider or physician and are not able to diagnose, treat or prescribe for any health condition. Services and fees are for the service of encapsulating your placenta, not for the sale of the capsules. Each woman will react to her placenta capsules in different ways. Some of the listed benefits of placenta consumption are supported by ongoing research, however these benefits have not been evaluated or approved by the United States Government or the FDA. It is your responsibility to determine whether using placenta capsules can be beneficial to your well-being postpartum.
CLIENT therefore holds sole liability and responsibility for consumption of the placenta in any of its forms.
CLIENT RESPONSIBILITY
PLACENTA HANDLING
CLIENT agrees to contact SPECIALIST via phone CALL as soon admittance to the hospital, birth center or midwives' arrival and then again after the baby is born. CLIENT agrees to keep placenta in their sight at all times to ensure it does not go to the lab where it will be contaminated by chemicals or other harmful substances rendering it unsafe for consumption. If the hospital must test the placenta, a small piece can be taken off the maternal side and sent to the lab, while the intact placenta is stored properly.
CLIENT agrees to then have the packaged placenta placed in a refrigerator (home birth) or cooler with ice (hospital or birth center). CLIENT is responsible for providing cooler ($15 fee for OP providing cooler) CLIENT understands that the same post-birth care instructions apply to C-sections. Placentas are good at room temperature (70°F) up to 4 hours.
CLIENT understands that it is imperative that these instructions are followed exactly. If not followed, the placenta cannot be processed. No refunds are given if CLIENT fails to properly handle/store/transport placenta.
Placenta must be kept in a cooler inside (2) 1-Gallon sized Ziplock bags in ICE, ICE MUST NOT BE ALLOWED TO MELT. ONCE MELTING HAS BEGUN IT MUST BE REPLACED. Please contact us for more details.
HISTORY
It is also your responsibility to inform me of any known bloodborne illness (es) or other health issues (such as HIV, hepatitis, etc.) that could place me or any others who may come in contact with your bodily fluids (specifically maternal and fetal blood as well as amniotic fluid) at risk. Some specific sexually transmitted diseases such as Hepatitis or herpes may preclude me from offering placenta encapsulation in my home/office space.
CONFIDENTIALITY
Our, Doulas of Orlando and Orlando Placenta, responsibilities include maintaining client confidentiality, committing to preparing and returning your capsules within 72 hours of receiving your placenta (usually within 24 to 48 hours), and upholding the highest standards of cleanliness, safety, and quality of Professional placenta preparation services. In the event that your assigned specialist is unable to be available for your placenta encapsulation, we will provide a backup placenta specialist who is capable of providing services.
It is important to understand that there may be circumstances in which your placenta cannot be used. Significant abnormalities of the placenta may necessitate your doctor or midwife sending your placenta to Pathology for further examination. Once the placenta has been released to Pathology, we will not be able to encapsulate without an additional waiver. Other conditions, such as signs of infection in the mother during labor, may mean that consuming your placenta could be harmful to your health. We will always consult with you prior to making a choice on whether or not your placenta is viable for ingestion. It should be possible to claim your placenta after caesarean surgery. It is important that you let us know if you have any health concerns or conditions which may affect the health of your placenta or the health and safety of anyone who may come into contact with your placenta.
REFUNDS
In the event your placenta is unavailable to you (ex. sent to Pathology and not released) or if your placenta has been contaminated with a bacterial infection, you will be entitled to a refund sans the amount of $100.00 for reserving our time. If you choose to terminate this contract due to change of mind within 7 days of your estimated delivery date, then you are no longer eligible for a full refund. If we have already taken possession of your placenta and you choose to not go forward with services, WE shall return your placenta to you for disposal. There will be no refund and payment will be due in full once preparation has begun, even if you choose not to take delivery of the finished capsules. If you are giving birth outside of the 20 mile radius to 32809 and we have left and/or arrived for pick up and the placenta is not available for pick up and therefore encapsulation no refund will be issued.
Additional monies paid (Balance) can be refunded in the form of a check or credited in the form of a Gift Certificate. Credit/Gift Certificate can be used towards any other service or products offered by Orlando Placenta or Doulas of Orlando, LLC.
Permission to Use Photograph/s
The CLIENT grants Doulas of Orlando, its representatives and employees the right to take photographs of the CLIENT's placenta and other products in connection with the above-identified subject with the knowledge that the CLIENT will not be named or in anyway identified with said photographs. The CLIENT authorizes Doulas of Orlando and its subsidiary: Orlando Placenta, its assigns and transferees to copyright, use and publish the same in print and/or electronically.
THE CLIENT further agrees that Doulas of Orlando and Orlando Placenta may use such photographs of the placenta, prints or cord keepsakes without identifying the client and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and Web content.
RESERVATION & PAYMENTS
Upon your registration and payment, SPECIALIST will reserve the date agreed upon. For this reason, the encapsulation deposit of $100 is non-refundable, even if the service is cancelled for any reason.
The CLIENT agrees that the $100(or amount agreed upon) deposit is to be paid at the time of registration. Remaining balance is due 4 weeks prior to EDD or at pick up of the placenta. If less than 4 weeks to EDD, full payment is due at time of Registering. $25 Last minute booking fee may apply if booked within 2 weeks of expected due date. A $50 booking fee may apply if baby has already been born and you decide to encapsulate within 4 hours of said birth. These fees would be non-refundable.
Payments may be made by cash, credit/debit card, money order or Square.
A Square invoice will be sent as default upon receipt of registration. If you prefer another method of payment, please send an email request to Luna@doulasoforlando.com
A $30 fee will be charged on any returned payments
I have read, understood, and agreed to the above information. I accept the responsibility of gaining possession of my placenta, and notifying my placenta specialist within 2 hours of my birth. I understand the importance of appropriate handling and storage of the placenta. By signing below I authorize the release of my healthy placenta to _Orlando_ Placenta's_Specialist_ for the purposes of placenta encapsulation and keepsake preparation for my own personal use.
All parties are legally bound to the services outlined and agreed upon within this signed contract.