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WELCOME
Hi! I am so glad you're here! Please fill out this form. Once you submit your responses I will personally reach out to you. I am grateful to have the opportunity to help you discover the gift of healing in Hemp. I will personally suggest products that match your needs. Please keep in mind that I am not a doctor, but a hemp wellness advocate with over three years of experience with CBD usage and troubleshooting. I am looking forward to working with you. Love, Jess
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2
Name
First Name
Last Name
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3
Email
example@example.com
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4
How did you find me?
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Instagram
Facebook
Recommendation
I know you!
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Please Select
Instagram
Facebook
Recommendation
I know you!
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5
I am interested in CBD for...
Please Select
Myself
My child
A family member
Multiple people
Please Select
Please Select
Myself
My child
A family member
Multiple people
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6
What are you seeking support for?
Check ALL that apply.
Daily Stress
Sleep
Mood Support
Irritability / Anger
Hormones
Gut Health
Pain
Inflammation
Racing / Attacking Thoughts
Energy
Focus
Other
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7
Tell me more about any symptoms you've checked. How long have you been dealing with them? Has anything given you relief?
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8
Have you ever tried CBD before? If so, what brand?
Describe your experience:
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9
Are you comfortable with the legal, trace amounts of THC (0.3% / 30mg)?
THC should be avoided if you are drug tested.
Yes
No
Undecided
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10
CBD comes in the form of tinctures or edible jellies. (A tincture is an oil which is absorbed sublingually, under your tongue.)
Do you have a preference?
Tincture
Jellie
Unsure
Either
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11
While effects of CBD are occasionally seen within days, it is not uncommon for it to take weeks, or even months to fully experience results. Are you willing to give CBD a minimum of 6-8 weeks of consistency?
Yes, absolutely!
I'll try, but consistency is hard for me.
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12
If you could earn product credit and commission by sharing your results and products used with others, would you be open to learning more?
Absolutely - I need income and a work from home wifi job.
Sounds fun! Maybe. I'd like to try products first.
Not at this time.
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13
Are you in the USA?
YES
NO
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14
Is there anything else you'd like to share with me?
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15
Please confirm that you are not a current Green Compass advocate or working with another advocate currently:
I confirm.
I need to switch advocates.
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