Under the Birch Tree
Welcome
About Samantha
Services & Fees
Testimonials
Contact
BLOG
FAQ
About the process
Quiz
Booking
Enquiry Form
Send a general enquiry and check for availability
around your EDD.
!!
this is not the booking form !!
Please check your junk mail folder for my reply!
*
Indicates required field
Name
*
First
Last
Your details are not accessed by anyone other than Samantha Birch. They will remain private and will never be shared.
Email
*
Your details are not accessed by anyone other than Samantha Birch. They will remain private and will never be shared.
Estimated Due Date
*
This information is vital to ensure availability for your service. I am aware that your baby will choose the date you birth.
Your suburb of residence & planned birth location
*
Essential information for collection and delivery of your placenta & products. Your details are not accessed by anyone other than Samantha Birch. They will remain private and will never be shared.
Have you taken any Covid-19 injections during this pregnancy? Please type "YES" if you had any of the Covid-19 injections during this pregnancy and how many weeks you were for each. Please type "NO" if you have not had any covid-19 injections during this pregnancy.
*
Research - ongoing as to the effect on the placenta after the covid-19 (MRNA) injections rolled out. If you have had the covid-19 injection/s during your pregnancy please add the weeks you had each one so we can discuss the safety of consuming your placenta.
I would like to ask....
*
Ask any questions you may have here. Your details are not accessed by anyone other than Samantha Birch. They will remain private and will never be shared.
I would like to go ahead and make a booking please.
*
Yes
Check here if you have chosen to make a booking and would like the Booking Form Password.
Submit
Who shared the placenta love with you?
Add all that apply
*
I am a past client
Midwife
Doula
Friend or Family
Hospital
Directory/FB Groups
Naturopath
Chiropractor
Acupuncturist
GP
Other Professional
Google
Other
Add the name of the person or business here.
*
Add the name of the person or business that you heard about this service from.
Submit
Welcome
About Samantha
Services & Fees
Testimonials
Contact
BLOG
FAQ
About the process
Quiz
Booking
