Herbal Wellness Suggestion

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Herbal Wellness Intake

This guide is for educational purposes and does not replace medical advice.

Name:

Email / Phone:

1. What are your top wellness goals? (Check all that apply)

Improve digestion / detox
Strengthen immune system
Support heart health
Reduce pain / inflammation
Reduce stress / anxiety
Improve focus / clarity
Improve sleep / dreaming
Mood & Beauty support
Respiratory / lung support
General wellness / minerals

2. Which symptoms do you experience most often?

Bloating / sluggish digestion
Frequent colds / low energy
Muscle or joint discomfort
Anxiety / racing thoughts
Brain fog / distracted
Restless sleep / vivid dreams
Stress-related body tension
Digestive cleansing needs

3. Safety Check: Are you on medications, pregnant, or nursing?

Your Handcrafted Matches:

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