Order a Fertility Plate Name * First Name Last Name Email * Phone Number (###) ### #### Drop off or Pick Up Pick up from my home in Tysons, VA. Please indicate you need your plate dropped off and provide your address below. I will contact you to let you know if I can do a drop off. Address Address 1 Address 2 City State/Province Zip/Postal Code Country Do you have any allergies or dietarty restrictions? Are there any ingredients, herbs, or spices you would not like to be included in your plate? * What phase(s) of your fertility journey are you on? * All the ingredients and materials I use are safe for each of these options - but I will adjust herbs, ingredients, and spices to maximize the effectiveness of the platter. Pregnant in my 1st or 2nd trimester Pregnant in my 3rd trimester Trying to conceive Trying to induce lactation Postpartum Select your broth preference * Chicken Mushroom Beef Select your dessert preference * All desserts are handmade and can be adjusted based on preference. Mango Sorbert Chocolate Mousse Yogurt and Berry Bark What date would you like your plate on or by? I prioritize making the plates according to when I am able to put the most attention, care, and love into my work. If you have a specific date you would like your plate on or by, please let me know and I will try to accommodate your needs! MM DD YYYY Are you able to pay for your plate? * I am not BIPOC and I payed $110 dollars to @laalidoula on PayPal as confirmation for my plate request. I am BIPOC and I made a donation between $50 and $110 for my plate to @laalidoula on PayPal as confirmation for reserving my plate. I am a T/GNC BIPOC and I am receiving my plate free of charge. I payed this amount to @laalidoula on PayPal as confirmation for my plate request. $ Thank you!
