Form
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Instagram Handle
How do you want me to send you your product match(es)?
Email
Text
DM me on Instagram
What are you seeking help for?
Sleep
Mood (anxiety, stress, depression, overstimulation)
Focus / Energy / Motivation
Pain
Immune Boost
Weight Management
Gut Health
Postpartum
Other
If other, what is your biggest concern?
Please elaborate on the symptoms you're dealing with. Are they chronic or acute (sudden onset)? How long have you been dealing with them? Has anything else worked in the past? Anything else you think I should know?
Have you used CBD before? If so, what were the results? What brand/product did you use?
Do you have any issues with a small, legal, NON-intoxicating amount of THC (0.3%) in your products? *You may want to avoid this is you are routinely drug tested*
I have NO issue with THC, whatever will make me feel better
I prefer/need THC free
I'm undecided
There are two ways to take CBD - tincture (oil) form or jellie (gummy) form. Which do you prefer?
Tinctures
Jellies
No preference
While the effects of CBD are sometimes seen quickly, it's not uncommon for it to take several weeks to fully experience results. Are you willing to give CBD a minimum of 6-8 weeks of consistency?
Yes, absolutely
I'll try but I'm impatient
Anything else I need to know?
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