Harmonize Your Menstrual Cycle Group Experience Application

We (De’Nicea and sponsoring company) are studying the effects of the supplement protocol on specific types of menstrual cycle presentations. While we know you are unique, there are certain patterns that signs and symptoms show up as and the protocol we’re studying addresses these particular patterns.

With that, there’s an application for you to complete and after review, you’ll be notified if you qualify for this Group Experience.

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Email *
Your Menstrual Cycle Experience
 Are you actively menstruating? (Even if it may be in varying cycle lengths.) *
Please select if you experience any of the following (check all that apply): *
Required
How long have you been experiencing these symptoms? And possibly received a diagnosis? *
Are you currently taking any hormonal interventions? *
If yes, what are you using? Why did you begin using hormonal intervention(s)? When did you begin?
What medications and/or supplements are you taking right now? If none, type N/A. *
About You
How old are you? *
Are you currently located in the United States? *
What's your ethnicity? (Please list all you're aware of) *
Are you actively trying to get pregnant? *
Required
Are you currently breastfeeding or pumping with intention to feed? *
Your Participation in the Group
If selected, are you able to begin January 8, 2023? *
Do you have access to a phone and/or computer to use Zoom and the group portal (both available as apps for ease of use?) *
Do you have access to a phone and/or computer to submit your weekly observations, including uploading pictures in the portal? *
Is there anything you can think of that would prevent you from completing the Group Experience? *
Are you aware that one (1) of the products is a hemp product that contains CBD and Farm Bill-compliant amounts of THC and are okay with this? 

Please be aware of this if you are tested, for example by an employer.
 *
If yes, what would do you see that you need to support you in completing the Group Experience?
What time zone are you in? *
Online Group Meetings are scheduled for 11am EST:
Sunday, January 8, 2023
Sunday, February 5, 2023
Sunday, March 5, 2023
Sunday, April 2, 2023

Are you able to attend these LIVE?
 *
This specific Group Experience is sponsored and has made it possible to offer this on a sliding scale. 

The enrollment fee represents an exchange where you, as a participant, are getting access to material, services and products otherwise offered at full fee in exchange for allowing De’Nicea to write case studies, which also informs the sponsoring company of any insights in product use and efficacy.

You’ll see a sliding scale (beginning at $100 and space for 'Other') in the application so you get to choose what you’re comfortable with offering and investing for the whole Group Experience (no judgment!), should you be accepted to the Group Experience.

After you’re sent acceptance to the Group Experience, an invoice will be sent to you for the selected amount you said you’d be willing to pay to participate.

Submitted payment officially secures your spot in the Group Experience. You’ll have 48 hours to submit payment after the invoice has been sent to you, otherwise the spot will be opened to someone else.

What enrollment fee do you choose?
 *
What's your name? *
Best contact number to text? *
What's your preferred contact email? *
Thanks for applying!
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