Fields marked with a * are required.
What method of encapsulation would you prefer?
*Please refer to the Placenta Services webpage for different method descriptions
Which shape would you like your cord keepsake made into?
(write name if known, otherwise let me know after the birth)
TERMS & CONDITIONS
I understand that…. (Please check all boxes to show you have read these terms).
A 50% deposit is required for your booking, and payment of your agreed fee is due in full upon release of the placenta to me, or by Paypal, or EFT to my bank account to be cleared prior to release.
My bank details are:
BSB: 112 879
Acc #: 055011575.
firstname.lastname@example.org - Please choose the ‘friends and family’ option or you will be charged to cover the excess fees.
Thank you for taking the time to fill out the NATURAL BEGINNINGS PLACENTA SERVICES CLIENT INFORMATION FORM.
Once submitted, look out for an automatic reply with further instructions. (If you dont find it, please check your Bulk or Junk folder). Once completed, I will be in contact with you within 48 hours to confirm receipt and discuss any questions you may have.
I look forward to processing your placenta into this wonderful medicine!