Contract | Pineapple Babies Birth Services

Name*
Address*
Email*
Phone*
Alternate Phone*
Payment*
- Venmo
- Cash
Enter Check # If Choosing Other
Placenta Pick-up Location*

Placenta Encapsulation Description
Placenta encapsulation is the process of preparing the mother’s placenta after the birth of her baby/babies by separating the membranes and umbilical cord from the placenta, rinsing and draining maternal/ fetal blood and dehydrating it to then be ground and placed into capsules for the mother to ingest as she sees fit. The ingestion of the placenta is known as “placentophagy.” The purpose of placentophagy by the mother is to reintroduce the beneficial vitamins, minerals, hormones, proteins, and other nutrients to her body following labor and birth to help restore a more balanced body function, prevent “baby blues” and the more serious postpartum depression, increase breast-milk production, shorten healing time, increase maternal energy levels, and provide an over-all feeling of wellness to aid in the transition between pregnancy and the early postpartum period in the woman who has just given birth.
Limitations and Disclaimer*
Pineapple Babies Birth Services is not a pharmacy, pharmaceutical representative, holistic practitioner, herbalist, or medical doctor. Benefits of placentophagy are supported by ongoing research but have not been evaluated by the Food and Drug Administration. Placentophagy, as it pertains to this contract agreement, is for natural nutritional supplementation and is intended solely for ingestion by the mother who has birthed the placenta/placentas and not for her family members, friends, or other individuals, is a natural nutritional supplement and, as such, cannot be guaranteed to produce specific results.
Service Description*
Pineapple Babies Birth Services (hereinafter referred to as PBBS) will pick up the client’s placenta/placentas at the specified location, depending on previous agreed upon arrangements made between PBBS and said client. Placentas picked up from hospitals must be brought out to the PBBS carrier’s vehicle for exchange. Proper cleanliness and preparation precautions for ingesting the placenta will be carried out by PBBS to ensure the highest quality of placenta encapsulation possible for the age and storage methods of the placenta/placentas before the encapsulation process. PBBS will deliver the finished encapsulated placenta capsules within 72 hours to the client unless pick up is arranged. Capsule drop-off or pick up MUST be within 3 days of capsules being complete for guaranteed freshness. This is a safety precaution because the capsules need to be refrigerated - They are not refrigerated prior to delivery to avoid condensation forming inside the bottle during transport. PBBS will provide a detailed written explanation of the proper storing and handling of the finished placenta capsules and suggestions for daily ingestion.
PBBS*
Will provide a detailed written explanation of the proper storing and handling of the finished placenta capsules and suggestions for daily ingestion.
Client Responsibility*
It is the client’s responsibility to notify PBBS as soon after the birth as possible (preferably the same-day as the birth itself) to request pick-up of the placenta/placentas by PBBS. Failure to do so may result in delayed placenta preparation and encapsulation and may cause decreased potency of nutrients, hormones, and other beneficial attributes of the placenta/placentas, and even spoilage of the placenta/placentas, which would render it unsafe for encapsulation.

It is also the client’s responsibility to discuss release of her placenta/placentas after her birth from the establishment where she delivers and to ensure proper storage of her placenta/placentas in a refrigerator or cooler with the placenta/placentas placed on ice (with a bag and towel separating so the placenta is protected from the ice) until it can be picked up or delivered to PBBS for preparation and encapsulation.
Client Responsibility*
It is also the client’s responsibility to inform PBBS of any known blood-borne illness/illnesses or other health issues that PBBS owner/employees, may become infected with through contact of bodily fluids (specifically maternal and fetal blood and amniotic fluid), such as HIV, hepatitis, STD’s, etc.
Fees*
PBBS Encapsulation Service includes:
• Pick-up of placenta/placentas to be encapsulated (Contact us to ensure service to your birth location)
• The full placenta preparation and encapsulation process
• Proper storage container for the completed placenta capsules
• Written instructions for proper storage & handling of the finished capsules
• Suggestions for ingestion amounts
• Delivery of the finished placenta capsules to the client’s home or other agreed upon location
Other Pick-up Location*
Signature*
The above outlined PBBS Encapsulation Service is provided for a total fee of $350.00.
Payment is due at the time of contract signing.
Date*
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