Partnership Interest Form

Welcome to Botanica Wellness LLC! We're thrilled to have you here. Our mission is to support your journey to better health and well-being with our range of wellness products and services. Whether you're looking for relief from chronic diseases, the common cold and flu, asthma, or mental health support, we've got you covered. Explore our offerings, including meditation classes, herbal remedies, soy wax candles, herb-infused oils, specialized blended teas, eczema butter, and body scrubs. We would love to support you on your wellness journey.

Full Name*

First NameLast Name

Phone Number*

E-mail

example@example.com

How did you hear about us?*

If other, please specify*

Which wellness products are you most interested in?

What specific health benefits are you looking for in wellness products?(e.g. Stress Relief, Immunity Boost, Better Sleep)

What are some symptoms or issues you would like to address?

Do you have any allergies or sensitivities? If yes, please list them below

What is your preferred method of using wellness products?

Topical ApplicationAromatherapyIngestion

Preferred method of contact?

Call/ TextEmailMeet w/ Owner

What is the best time and date to reach out to you? Appointment

Product Interest Form