Placenta Encapsulation Service Agreement


I, the client, have asked Purple Lotus Doulas to prepare my placenta in capsule form for my own personal use. As a condition of this service, I make the following assertions:

I agree that:

I am paying for the encapsulation service only.

My placenta does not contain any known, transmittable diseases such as Hepatitis-B, Hepatitis-C or HIV/AIDS.

I am fully responsible for the release of my placenta from my birth place, including signing any appropriate placenta release forms. I understand that I am responsible for obtaining my placenta if I am giving birth at a hospital that does NOT provide placenta release forms.  I am also responsible for transporting said placenta to the location at which it is to be encapsulated, unless other arrangements have been made with my encapsulator.

The placenta has been handled in a manner appropriate for safe food preparation since the birth. I will contact Purple Lotus Doulas within 24 hours of my birth.

I understand that:

I will not hold Purple Lotus Doulas responsible if my placenta is accidentally damaged during the encapsulation process.

Purple Lotus Doulas makes no guarantee of my personal results from the capsules.

The capsules should not be taken during times of an active infection, such as influenza, sinus infection, mastitis, surgical site infection, etc. I understand that taking the capsules may temporarily worsen the symptoms during an active infection. (Capsule consumption can be resumed as soon as the active infection has cleared, e.g. you’ve been fever-free for 24 hours.)

Purple Lotus Doulas cannot estimate or guarantee the amount of capsules yielded from my placenta.  This is a factor of the overall size of the placenta, its usable portion and the encapsulation process itself.

Purple Lotus Doula agrees:

We will begin the encapsulation process as soon as possible following your birth at a mutually agreeable time, ideally within the first few days postpartum. However, due to circumstances out of our control, this is not always possible. If we cannot get to your placenta within the first few days postpartum, we will give you handling instructions until we can begin the encapsulation process.

We will process your placenta according to the Traditional Chinese Method — steaming for approximately 30 minutes followed by dehydration at 105 degrees, then ground and encapsulated.  If you choose the Raw Method, the process is identical, but we do not steam the placenta and the dehydration temperature is 165 degrees.

We will follow universal precautions when handling your placenta.

Your placenta will not come in contact with another placenta during the process.

We will do our very best to return your capsules to you in a timely manner once the encapsulation process is complete. While we often can deliver your completed capsules within 2-3 days from the time of completion, it may occasionally take as long as a week until we we are able to deliver your completed capsules, due to circumstances outside of our control (such as the encapsulator being at a birth, having other scheduled commitments, major holidays, etc).

Fees:

Fee for encapsulation services prepared in the Traditional Chinese Method (steamed) OR the raw method is $275.

A $25 retainer is required to book encapsulation services for future due dates.

The $25 retainer fee is non-refundable. It is to secure your place in our encapsulation schedule. The remaining balance will be due by cash or credit card before we can start your encapsulation. In the event that you do not contact us following your birth, you could not obtain your placenta, or your placenta is not safe for encapsulation (e.g. uterine infection at time of delivery), the retainer fee will not be refunded, but no further fees are due.

For those requesting service without a prior retainer, the full amount is due at the initiation of service.

Discounts:

Discount when utilizing any other PLD service: $75 off

Discount for repeat clients not utilizing other services: $50 off

Discounts cannot be combined.

Additional Fees/Options:

Parents of multiples (twins, triplets, etc): $50

Vegan Capsules: $15

Placenta tincture: $20

Placenta pick-up/delivery outside of the St. Louis metro area: cost TBD based on distance

Liabilities:

I understand that the act of ingesting placenta in any form has not been tested, nor approved by the FDA, and I ingest this at my own risk. The services offered are not intended to diagnose or treat any condition. By choosing to utilize encapsulation services, I take full responsibility for using the remedy.

Furthermore, I release Purple Lotus Doulas from any and all liability from the encapsulation process or for any effects I may experience after choosing to take the capsules.

Placenta Encapsulation Service Agreement

    Agreement of Terms & Conditions for Service

  • Client Information

 

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