MoldCo | Join the waitlist

1
What should we call you?* This field is required.It's nice to meet you.
First Name
Last Name
2
What’s the best email to reach you?* This field is required.We’ll use this to send you next steps and updates.
example@example.com
3
And your phone number?* This field is required.We only text you with important info or scheduling help.
Please enter a valid phone number.
4
Where are you located?* This field is required.We are rolling out stay by state and we will let you know once Malco is available near you.
Please Select
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
5
Let’s talk about your space. Are you currently being exposed to any of the following?
A water-damaged building in your home or workplace
Visible mold indoors in your home or workplace
Noticing musty, damp, or earthy smells in your home or workplace
Not sure
No
6
Have you previously lived, worked, or stayed long-term in a place with known or suspected mold?Mold exposure often hides in homes and offices.
Yes - Confirmed mold issue
Yes - Suspected but unconfirmed
Not sure
No
7
Roughly when was your first known mold exposure?
Less than 6 months ago?
6-12 months ago
1-3 years ago
Over 3 years ago
Not sure
8
Now, let's talk about your symptoms. Have you had any of these gut or metabolic issues for at least a month?* This field is required.Select all that apply.
Frequent abdominal discomfort or pain
Changes in appetite (increase or loss)
Ongoing diarrhea, constipation, or both
Trouble tolerating certain foods or medications
Histamine reactions (e.g., flushing, hives, heart racing)
Unexplained weight gain or loss
None of these / not sure
Other
9
In the past month, have you experienced any of the following cognitive or nervous system issues?* This field is required.Select all that apply.
Brain fog or trouble thinking clearly
Trouble concentrating
Poor short-term memory
Difficulty recalling words
Difficulty learning new things
Easily disoriented or confused
Anxiety
Depression
Irritability or mood swings
Other
10
In the past month, have you experienced any of the following cognitive or nervous system issues?* This field is required.Select all that apply.
Brain fog or trouble thinking clearly
Trouble concentrating
Poor short-term memory
Difficulty recalling words
Difficulty learning new things
Easily disoriented or confused
Anxiety
Depression
Irritability or mood swings
Headaches
Migraines
“Ice pick” or stabbing head pain
Light sensitivity
Vertigo or dizziness
Tingling, numbness, or unusual sensations
Tremors or tics
Unusual pain or body sensitivity
Temperature dysregulation (feeling hot or cold without cause)
Trouble sleeping
None of these / Not sure
Other
11
We're almost done. Can you let us know if you had any of the following symptoms?* This field is required.Select all that apply.
Persistent cough
Ongoing sinus congestion or pressure
Frequent sneezing, post-nasal drip, or runny nose
Shortness of breath or difficulty breathing
Wheezing or asthma flare-ups
Nasal polyps (growths in the nasal passages)
None of these / not sure
12
Have any of these stuck around for a month or more?* This field is required.Your immune system might be working overtime. Select all that apply:
Ongoing body aches
Joint pain or stiffness
Unusual physical weakness
Hair thinning or hair loss
Constant fatigue
Morning stiffness that eases later in the day
Frequent or recurring fungal infections (skin, nails, etc.)
None of these / Not sure
13
Did a medical provider refer you to us?
14
Messaging opt-inWe use SMS to keep you updated on your waitlist status.
By checking this box, I agree to receive marketing text messages and phone calls regarding products, waitlist status and other promotional events at the phone number provided above to MoldCo. Message & data rates may apply. Reply HELP for more information, STOP to cancel at any time, and START if you would like to resume.
I agree to receive customer support text messages as needed for the orders that I have placed at the phone number provided above to MoldCo. Message & data rates may apply. Reply HELP for more information, STOP to cancel at any time, and START if you would like to resume.
15
How did you hear about MoldCo?* This field is required.
Google search
Facebook or Instagram
Reddit
Doctor referral
Podcast
Mold inspector or remediator
Another patient
Other
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