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Encapsulation Request Form

This document provides information about placenta encapsulation and other placenta-based services offered by Casi Delaat-Russo. The services include encapsulating the placenta into capsules with various herbs, creating tinctures, making salves, and printing photos from the placenta. It lists the ingredients used and provides instructions for taking the encapsulated placenta capsules and tinctures. Payment details and contact information for Casi Delaat-Russo are also included.

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Casi Delaat- Russo
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182 views2 pages

Encapsulation Request Form

This document provides information about placenta encapsulation and other placenta-based services offered by Casi Delaat-Russo. The services include encapsulating the placenta into capsules with various herbs, creating tinctures, making salves, and printing photos from the placenta. It lists the ingredients used and provides instructions for taking the encapsulated placenta capsules and tinctures. Payment details and contact information for Casi Delaat-Russo are also included.

Uploaded by

Casi Delaat- Russo
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd

Casi Delaat-Russo Questions!

Please contact me@ 616-690-5132


Mother Moon Placenta Services
Casi Delaat-Russo
616-690-5132
367 Indiana Ave Apt A
Grand Rapids MI, 49504
I plan to do the following with my placenta:
o Encapsulate
o Tincture
o Salve
o Prints
Encapsulation:
o Gelatin Capsules
o Vegetarian Capsules
o Any 2 of the following herbs:
o Alfalfa
o Nettle
o Red Raspberry Leaf
o Motherwort
o Lemon balm
o Blessed thistle
o Echinacea
o Rose hips
o St. Johns Wart
o _________________
Tincture:
o Alcohol based
o Glycerin Based
Salve: (includes all)
o Comfrey
o Calendula
o Goldenseal
o Arnica

Prints: (includes 2)
o Black
o Silver
o Pink
o Purple
o __________
Please have payment and form ready at
the time the placenta is picked up or at
36 week appointment:
___ Encapsulation with 2 herbs $100
___ Each additional herb $2
___Vegetarian Capsules $5
___ Tincture $25
___ Salve $25
___ Prints $5 (for two prints)
___ Simply Born 25% off Encapsulation
___ Total (Cash or Check)
Free cord dehydration at your request!


Casi Delaat-Russo Questions! Please contact me@ 616-690-5132
Instructions:
Encapsulation:
o Take 1 capsule up to 3 times a day.
Then slowly decrees amount to 1
capsule once a day unless you
continue to feel fatigued or unable
to cope. All in all the does depends
on how you are feeling.
o Keep capsules in refrigerator while
in use and can be moved to freezer
for long term storage.






















Tincture:
o Can be added to water or taken
directly under the tongue. 5-10
drops 3 time a day.
Salve:
o Can be put on cesarean incisions
or perineal tears or lacerations as
needed.

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