Placenta Contract Form
After you fill out this contract please complete "check out" at
Please fill out this form completely in order to prevent any delays in scheduling of services.
$50 Deposit is due at this time to reserve your encapsulation.
I will reserve a spot for you, if deposit has not been received by day 7 I will be forced to open the booking backup for the next person. If you're unable to pay the deposit at this time that is okay. Please complete the contract and message me. (209) 225-6870. Payments can be arranged for balance and made at your convenience prior to placenta pick-up.
I respect your right to privacy. All answers provided are held in strictest confidence.
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