Placenta Encapsulation Services Agreement
I
___________________________, have asked Amanda Hartman to
prepare
Printed Client Name
Placenta Encapsulation
Specialist (PES)
my baby’s 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 transmittable diseases such as Hepatitis-B, -C or HIV/AIDS.
My care provider and I
have determined that my placenta is healthy and suitable for encapsulation.
The placenta has been
handled in a manner appropriate for safe food preparation since the
birth.
I understand that:
The PES views each
placenta as a sacred connection between mother and child and will treat
it
accordingly. I will not
hold the PES responsible if my placenta is accidentally damaged during
the encapsulation process.
The PES does not
determine whether my placenta should be consumed and makes no guarantee of
my personal results from the capsules.
I understand that all preparations of my placenta will happen in the house of the PES, which is a sterile environment for my placenta.
The capsules should not
be taken during times of illness, such as the common cold, flu, or mastitis.
I understand that taking the capsules can make these conditions
worsen.
The PES uses the Raw
Dehydration Method. This method involves
slicing the placenta while fresh and raw, dehydrating it immediately. It is widely held that the hormones are more
likely to be bioavailable when the placenta is processed raw.
Limitations and
Disclaimer:
The is not a pharmacy,
pharmaceutical representative, holistic practitioner, herbalist, or medical
doctor and cannot diagnose, treat, or prescribe for any health condition. Services and fees are for the preparation and
encapsulation of the placenta, not for the sale of the pills. No specific benefits or effects are
promised. Individual results may
vary. The benefits of placenta
consumption are supported by ongoing research, but have not been evaluated or
approved by the FDA. It is your
responsibility to determine if placenta preparation and consumption may be of
benefit to you.
Client Responsibility:
It is your
responsibility to notify me as soon as possible after the birth to make
arrangements for transfer of your placenta.
Failure to do so may result in delayed placenta preparation and
encapsulation, and can cause decreased potency of nutrients, hormones, and
other beneficial attributes of the placenta.
Improperly handled placentas are susceptible to spoilage and all
placenta work is done at your own risk.
It is your
responsibility to discuss the release of your placenta with your primary health
care provider as well as the facility you will be birthing in. Please make sure your placenta is
refrigerated or kept on ice until it can be picked up or delivered for
preparation and encapsulation.
Your placenta may be
kept at room temperature for 3 hours following your birth. After that, it should be placed on ice or in
a refrigerator. If it is going to be 3
or more days before your placenta can be processed, it should be frozen. A frozen placenta will require 2 additional
days for processing, since it must be gently defrosted prior to being
dehydrated.
I release Amanda
Hartman and the PES (if other) from any and all liability for any
effects I may experience
after choosing to take the capsules.
________________________________
_____________________________
Signature
Date
