SF Placenta Encapsulation Contract
Limitations and Disclaimer:
I understand that Tomi Hougen is not a pharmacy, pharmaceutical representative, holistic practitioner, herbalist, or medical doctor. No specific benefits or effects are promised. This service has not been evaluated by the FDA. She makes no medical treatment claims. Services provided are not clinical, pharmaceutical, or intended to diagnose, treat, or cure any condition. Families who choose to utilize these services take full responsibility for their own health and product usage.
Client Responsibility
I will notify my doctor or midwife of my wishes to take my placenta home. Failing to mention this may result in the placenta being disposed of quickly by the healthcare staff.
Within 2 hours of the birth, I will make sure my placenta is refrigerated or stored in a cooler full of ice until it can be picked up for preparation and encapsulation. Improperly stored placentas are susceptible to spoilage and all placenta work is done at your own risk. SF General and UCSF are the only hospitals in SF Bay Area that will generally allow you to store in their fridge, so please try to remember to bring a small cooler if birthing at a hospital.
I understand that Tomi does pick ups between 9am and 9pm.
I understand the hospital containers can vary in size, so to ensure it will fit properly in my particular cooler, I know Tomi recommends bringing gallon size freezer strength ziplock bags (2 of them so it can be double bagged) This is what my support person will hand the nurse to place my placenta in. If my cooler has a soft exterior, I know it is recommended I bring 2 more gallon size zip locks for the ice to go in. If I have any questions about how to properly store my placenta after the birth, I will phone or text Tomi ahead of time.
I understand it is up to me to decide if using the placenta will benefit me.
I understand that my placenta will be handled and processed by a trained and educated encapsulator.
The encapsulator is not responsible for the condition of the placenta before she receives it.
I do not knowingly carry any transferable blood-borne pathogens and if I do, I will notify Tomi in advance.
- Tomi Hougen does not determine whether my placenta is suitable for consumption and makes no guarantee of my personal results from the capsules.
- I release Tomi Hougen from any and all liability for any effects I may experience after choosing to consume my placenta.
- I understand that a maternal or fetal infection at or immediately following the time of delivery is a contraindication to encapsulation or, an allergic reaction to meds received during labor. It is not recommended to encapsulate in these cases.
- Meconium is not a contraindication for encapsulation
- GBS is not a placenta encapsulation contraindication. Steaming reduces harmful bacteria. GBS is eliminated after being exposed to moist heat at a temperature that is at least 55° C (131° F) for 30 minutes.
- Services and fees are for the preparation of the placenta and NOT for the sale of the pills or use of another’s placenta.
Tomi is not responsible for lost, held, or damaged packages, mis-delivery errors via carrier or incorrect shipping info. So far there have been no shipping issues reported.
For the Specialist:
*I am not a medical professional and will not diagnose or treat any health condition.
*I have been trained in the proper safe storing, handling, and preparation of your placenta.
*In the unlikely event of an unforeseen circumstance, I have multiple colleagues that will be my backup.
*I guarantee that I handle your placenta with respect and care and that you are getting your placenta back in the form that you have requested.
*I will return your finished package within 4 days postpartum, or at the earliest convenience after that time.
Payment:
To secure placenta services, there is a NON-REFUNDABLE deposit of $100 due through Venmo, Paypal, or Zelle (coming soon)
Venmo handle:
@Tomi-Hougen
Security code: 4381
Paypal Link:
www.paypal.me/sfplacentalady/100
For the remaining balance, I will make full payment for the encapsulation upon delivery of my items.
In the case of cancellation by the client:
*The deposit is non-refundable; however, in the unfortunate event of one the following, a client may receive 50 percent of their deposit returned upon request:
Chorioamnionitis (uterine infection)
Blood infection
Allergic reaction to a drug used during labor
Morphine accidentally administered directly into the placenta during an emergency c-section.
Alternatively, In the event of any of the above, the $100 deposit can be used towards other services of Tomi’s, such as an art print(s) or sacred burial ceremony.
I understand I may need to request hospital staff save/release their placenta “for cultural reasons” in this case. (..If I am signed up for blood or paint print, then the $100 deposit will go towards these services instead. I may need to inform the hospital staff to save/release my placenta “for cultural reasons”)
By signing below, I agree to the TERMS AND CONDITIONS:
To indicate your acceptance of the above, sign the attached document.