Get Your Personalized CBD/Cannabis Routine
If you fill out this form, Haley will respond with a personalized YouTube video just for you!  

First come, first served ;)

This video will be shared publicly on YouTube and will include your preferred first name only.  All recommendations are based on Haley's experience and training in the legal cannabis industry and are not meant to take the place of a qualified health care professional.  

Email: cannabiscoachhaley@gmail.com 
Instagram: @cannabis_coach_haley
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Email *
Name (please include a name you feel comfortable sharing -- can be a nickname or Instagram handle if you like) *
Age *
City, State *
Do you have access to medical cannabis in your state? *
Name/website of cannabis dispensary closest to you:
Are you interested in: *
Why are you interested in using CBD/Cannabis? :) *
Main reasons for trying CBD/Cannabis --choose your top 3 *
Required
Anything you'd like me to know about your health? *
What would you like to know about CBD/Cannabis? *
Which of these best describes your history with CBD/Cannabis? *
Required
Any concerns about using CBD/Cannabis? *
Required
Anything you'd like to say about past CBD/Cannabis experience?
When you see this list of CBD/Cannabis options, what appeals to you the most? *
Required
Anything else you'd like me to know about you? :)
Once you fill this form out, Haley will make a personalized YouTube video just for you! Thanks for your time! :)
You will be notified via email once your video becomes available!
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