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Where are you planning on giving birth?
Please tell me about your upcoming birth (check all that apply)
What benefits of placenta encapsulation are you most looking forward to? (check all that apply)
How would you like your placenta prepared for encapsulation?
Basic heated method (cleaned, steamed, dehydrated, ground into a fine powder and encapsulated (RECOMMENDED)
Raw method (cleaned, UN-steamed, dehydrated, ground into a fine powder and encapsulated
Mix of both options
Are you Group Strep B positive? You will only know this after the culture which is usually done at 36 weeks
Yes
No
Not sure yet
After preparation your placenta powder is put into capsules. What type of capsule do you choose?
Red colored gelatin capsules
Clear vegetarian capsules
Strawberry flavored capsules +$10
Lime flavored capsules +$10
Would you like me to take photos of your placenta and email them to you? (No extra charge)
Yes
No
What shape would you like me to create from your baby's dehydrated umbilical cord as a keepsake item? (No extra charge)
Heart
Spiral
I definitely do not want a keepsake
Are you interested in having a tincture made from your placenta? This is an optional add on. Tinctures will be ready after six weeks whereas your capsules will be ready in just one day.
No tincture. I just want the capsules.
One 4oz tincture (+$35)
Two 4oz tinctures (+$45)
Are you interested in having a placenta print made on high quality water color paper? (This is an optional add on for $20
Yes
No
How would you like Womb Service to receive your placenta after birth?
Pick up right from your hospital room immediately after the birth (INCLUDED)
I will have someone deliver to Womb Service for a $50 discount (Drop off zip code is 92111)
How would you like to pay? Payment can be made after the birth and is not required ahead of time.
Venmo
ApplePay
Zelle
Cash
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