Yes! I would like to know more.

Thank you for your interest in learning more about essential oils!

Essential oils can help support health and wellness in so many areas of our daily life.

Let's get you started on your new journey!

First, share how I can connect with you and your level of essntial oil knowlege. This will help me provide the best advice I can. Providing your phone number is optional, but if you'd like me to call you, I will need your number.

First Name *

Email *

example@example.com

Phone Number - optional

Area Code Phone Number

How did you here about me? *

Referred by a friend Social media Internet search Other

What is your experience using essential oils? *

I have not used essential oils I have occasionally used essential oils I use essential oils a few times per week I use essential oils everyday

What are your top three wellness goals? These answers will help me better assist you in finding and reaching results for your health and wellness goals.

Wellness goal Wellness goal Wellness goal

What are your top three health concerns? These answers will help me provide suggestions for essential oils and essential oil infused supplements that can assist you in targeting and reaching results you are looking for.

Wellness concern Wellness concern Wellness concern

I'd like to know more about: *

1. Digestive support 2. Emotional support 3. Focus and energy support 4. Immune support 5. Head, neck and muscle tension support 6. Seasonal and/or environmental support 7. Sleep support 8. Women's health support

Feel free to share a bit more about what you are interested in learning about or the wellness support you are looking to find.

Do you have an account with doTERRA? *

No Wholesale Customer account Wellness Advocate account

Are you currently working with someone who uses doTERRA Essential oils? *

Yes No

If you are not working with a doTERRA Wellness Advocate or have your own account, please choose one sample you would like to receive.

If you selected to receive a sample, please share where your sample should be mailed.

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

I invite you to consider hosting an essential oil workshop! I offer a free hostess gift on the day the workshop is held. (Workshop can be online (Facebook or Zoom), or in-person if you are within a comfortable driving distance for me.

Yes - let's chat about it! No thank you.

I invite you to learn more about creating lifestyle rewards by using and sharing essential oils and essential oil-infused products with your friends, family, and others you meet. Is this something you would enjoy and be interested in hearing more about?

Yes Maybe No, not at this time.

I look forward to sharing with you, inspiring you, and finding solutions that work! I am happy to share my expericenses with you.

Please confirm that you understand this: Pure and Simple Oils and their affiliates are not healthcare professionals and make no claims that we are. What we share has not been evaluated by the Food and Drug Administration. Our suggestions and products are not intended to diagnose, treat, cure, or prevent disease.” *

I understand

Please verify that you are human *