Christa Delgado
Educator & Wellness Advocate
Full Name
*
First Name
Last Name
Phone Number
*
Email
example@example.com
Have you ever tried CBD?
Yes, I tried it in the past
Yes, I currently take it
No, but I'm curious
If you answered yes, did you have guidance with which products are right for you and how to dose properly?
Yes
No
Regarding your health (check all that apply)
Sleep
Pain
Gut Health
Anxiousness, stress, feeling overwhelmed
Signs of aging, hair loss
Skin disorders, general skin irritation
Do you have a pet that gets nervous during storms, car rides, vet visits, fireworks or a senior pet?
Yes
No
Do you know child who has trouble with focus or staying organized and calm during the school day or otherwise?
Yes
No
Do you exercise regularly, if so what form?
Please share any additional concerns about your health or someone you care about.
Would you like information on our CBD business opportunity or ways to earn free products?
Yes! I would love to earn extra income while helping others.
No thank you.
I would be interested in knowing how to earn free cbd products.
I’m interested and would like to schedule a quick call to discuss what would be best for me.
As soon as possible
This week please
Next week
If you were referred to me, who can I thank?
Submit
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