Placenta booking form
Placenta remedies T&C
PLACENTA REMEDIES BOOKING FORM
What's your name?
What’s your phone number?
What’s your email address?
What’s your birth partner's name?
Birth partner's phone number?
When is your baby due?
Where are you planning to birth?
Which hospital are you booked in with?
Have you spoken to your midwife about your choice to encapsulate?
Have you ever tested positive for AIDS, HIV, Hepatitis B, Hepatitis C or CJD?
For the health and safety of yourself and your Specialist we must have an honest answer to the above question
Have you tested positive for Group B Strep in this pregnancy?
If yes, please select Steamed Preparation.
Please update me if this changes prior to your birth
Have you smoked during this pregnancy?
For the health and safety of yourself we must have an honest answer to this question
Have you been prescribed regular medication during your pregnancy?
If YES, you must seek approval from your prescribing doctor before your booking can be accepted
Which service do you require?
Simple encapsulation - £220
Steamed encapsulation - £220
Combination (50/50) - £250
Placenta tincture - £70
Placenta smoothie - £70
Complete package - £350