Questionnaire Questionnaire Please fill in your responses to the questions below. After submitting you will get a formulation recommendation and specific instructions on usage. We are here to help! Check all that apply to you: * Pain – General Pain – Localized Falling asleep Staying asleep Anxiety Digestion – Upper Digestion – Lower Autoimmune issue(s) Mental fog / Focus deficit PMS / Post-PMS / Hot Flashes Mood / Depression Blood sugar / Diabetes / Pre-diabetes Eczema / Psoriasis / Acne Which issue(s) of those that you checked above is/are the most important to you? Are you taking any medications? Have you tried CBD before? If so, what did you use, what dosage, and how were your results? Additional comments or details: Please provide your email so we can get back to you: * If you are human, leave this field blank. Submit Δ
