Placenta Initial Registration Form

Placenta Initial Registration Form

(This information is ONLY used for communication between us and for this process. All information gathered herein will be kept confidential and is only used for the initial purpose of discerning if your placenta is safe to handle and/or for you to consume. Answers to any of the following do NOT necessarily mean it can or cannot be done. This info just helps to give me a general idea of the situation and to gauge if we need to chat about anything in more detail.)