Alacarteplacentas Booking Form Maggie Vaughan info@alacartedoula.co.uk 07542447075 Terms and Conditions
1. Placenta Remedies Network (PRN) members provide placenta services including encapsulation, fruit/placenta smoothies, essences, tinctures, prints and the sourcing of homeopathic placenta remedies.
2. PRN members have been trained and certified by a PRN accredited trainer to provide placenta services to the public. PRN does not insure specialists, and the client’s relationship is solely with the specialist not with PRN.
3. Whilst not mainstream the benefits of consuming one’s own placenta post-birth are based on research studies, articles and testimonials. Research is ongoing and the specialist does not give any warranty or representation that benefits are guaranteed.
4. Clients who utilise these services take full responsibility for their own health and for researching and using the products created from their placenta.
5. The client agrees that neither PRN or the specialist is liable, and they do not take responsibility for any effects the client may experience before, during or after consuming the products unless resulting directly from negligence of the Specialist.
6. PRN recommends clients’ placenta products are solely for their own use.
7. PRN members will not provide services for clients who have ever tested positive for HIV/AIDs, Hepatitis B, Hepatitis C and/or CJD
8. All methods of decontamination and disinfection of equipment used by PRN members adhere to Government guidelines and regulations. Placenta smoothie blenders are single use and then disposed of.
9. The specialist retains ownership of any photographs/prints taken of the client’s placenta, (unless ordered and paid for, )which may be used anonymously for education, advertising and promotional purposes. The client must inform the Specialist if she does not wish photos/prints to be taken of her placenta.
10. Your PRN member aims to prepare the placenta within 3 days of its collection, however no guarantee can be given. Please see documents ‘Safe Storage Guidelines’ and ‘Placenta Care’ for guidelines on safe handling and storage of your placenta.
11. PRN members do not take responsibility for damaged or lost placentas before the placenta comes into their care.
12. The client agrees to store their placenta in the Safe Storage Pack provided by the Specialist or in a refrigerator within 30 minutes after birth of the placenta and agrees to ensure her placenta remains chilled until collection.
13. The client agrees to contact her specialist as soon as possible and within 2 hours after birth to arrange safe collection of her placenta.
14. The client consents to the removal of the placenta from the hospital (or home) by the specialist to the extent necessary for the performance of the services.
15. Homeopathic remedies may be re-ordered via the PRN homeopath, who will keep a 1C copy of the client’s original sample for 5 years.
16. The client consents to the safe disposal of the original placenta sample when used for homeopathic remedies unless the client indicates in advance that they would like the sample returned. Fees apply.
17. The Client may consent to complete an online Feedback Survey sent by email approx. 6 weeks following the encapsulation and the Client agrees to answer the questions honestly to help provide statistics and testimonials for PRN.
18. Payment must be received in full before the delivery of the order in full or in part.

By submitting this form you agree that all the information you have given is correct and to the best of your knowledge. You also agree to the Terms and Conditions above and you have thoroughly read the "Guide for Expectant Parents" on the Placentremediesnetwork.org. website and will follow all the guidelines provided to you by your Specialist in the documents titled 'Placenta Care' and 'Safe Storage Guidelines' ensuring the proper care and safe storage of your placenta
Sign in to Google to save your progress. Learn more
Email *
Full name as used in maternity notes *
Estimated Date of Birth or ELCS date *
Telephone no. *
FULL address *
Birth Partner's full name and contact no. and any Doula's name and contact no *
Planned place of birth.. If home please also name hospital if transferred. *
1st baby? 2nd, etc.twins? *
Have you ever tested +IVE for Hep B, Hep C, Aids, HIV or CJD. *
Have you smoked during your pregnancy? *
Have you been prescribed regular medication during your pregnancy? If yes it is up to you to seek approval from your prescriber before your booking can be accepted. We cannot comment on medications. *
any relevant allergies?
How did you hear about my placenta services *
I will lend you a Safe Storage Pack (SSP) to ensure a safe chill chain for your placenta. I ask for a £50 deposit paid on booking which will be set off against the final bill which is due before the deliver of the capsules etc. Please transfer deposit to Margaret Vaughan 09-01-28 72697383. If your EDB is imminent please get in touch asap to discuss.
Clear selection
yes
no
Fruit Placenta Smoothie £45
Simple capsules £195
Steamed capsules £195
mix of simple and steamed capsules £220
DIY Tincture 250mls £40
Homeopathic remedies £60
Mothers' Facial Oil, 100 mls £40
Body balm, 100 mls £40
Infused Oil to add to cosmetics gratis with cosmetics order
Placenta Print (may take a couple of weeks) £25
capsules + 2 other items = 5% discount
Clear selection
*
Yes
I have transferred the deposit
I have discussed any medications with my provider
I have read the terms and conditions above
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy