What's All The Hype? Essential Oil Study Group Questionnaire

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Welcome! We are so glad you are joining us! We would love to create a customized Starter Pack of oils just for you! In order to receive the most benefit, there is a tidbit of info. you'll want to share with us. We will email you to let you know if you are selected to participate in our next study group. To participate in our essential oils study, you are agree to participate in this 7 day essential oil experience on Facebook with us - it's easy, fun, and educational. Please look for an email from Kellyandcoreycarothers@gmail.com

Email *

Your first and last name *

Cell Phone Number (so we can confirm receipt of your Starter Pack and provide guidance) *

Who invited you to participate in this group? *

If you are local to Central PA, you will pick your Starter Pack up at one of our partner businesses. If this applies to you, please select which business you will be visiting to pick up your pack. *

Boutique on Pomfret @ 16 W Pomfret St, Carlisle, PA

Plum Bottom Shoes @ 2619 Brindle Dr, Harrisburg

I am not within a reasonable distance of any of these locations Please ship my oils (list address in next section)

I already have my Starter Pack or have already made arrangements to get it.

If you need your Starter Pack shipped, please list your mailing address here

Have you ever used essential oils? If yes, Where do you get them? (please let us know if you are already using doTERRA and if you already have a support person in place) *

If yes, What have you used them for?

Mark any of the symptoms that you currently experience *

digestive discomfort/upset

Difficulty relaxing

Trouble falling asleep and/or staying asleep

Struggle to manage stress

Chronic pain and inflammation

occasional pain and inflammation

imbalanced mood

Required

Please select which Starter Pack you would like *

Digestion

Sleep

Pain and Inflammation

Stress

Do you have any other health/wellness goals or anything else you would like to share in advance of the group?

Send me a copy of my responses.

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