Wild Sanctuary Medicine Apothecary Order Form
Visit WildSanctuaryMedicine.com for details including ingredients, recipes & other offerings.  
Balms | Tinctures | Tea | Honey | Hydrosol | Herbs | Zines | Tick Kits | Seeds (preorder)
1. Place your order by filling out the form below 2. Check email (including SPAM) for invoice within 1 week. 3. Sliding Scale Donation via Venmo or Paypal | Must receive donation before shipping 4. Order Ships
5. Enjoy :
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Order Date *
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Full Name *
Phone Number *
Email *
Full Mailing Address: Street Number & Name | City | State | Zip Code *
Roasted Burdock Root - WI grown
BALMS. List Quantity & Size in "Other"
TINCTURES. List Quantity in "Other"

Vibrant Heart: Tulsi, Lemon Balm, Rose, Linden, Hawthorn, Lady's Mantle, Motherwort

Mushroom: Reishi, Birch Polypore, Maitake

Thrive: Milky Oat Seed, Tulsi, Astragalus, Ashwagandha, Eleuthero, Schizandra

Gentle Sleep: Milky Oat Seed, Tulsi, Lemon Balm, Rose, Catnip, Peach Leaf, California Poppy

Deep Sleep: Valerian Flower, Hops, Passionflower, Lemon Balm, Blue Vervain, Peach Leaf, Catnip, California Poppy
TEA BLENDS. List Quantity in "Other"
TICK KITS: Herbal Education and Self-Empowerment for Tick Bites (to order additional kits, please list quantity in "Other") | $30-60
Seeds: PRE-ORDER | Annual & Biennial 20 seeds per pack
$2-$4 per pack sliding scale suggested donation
Note: Seeds are currently available for **preorder only.** Seed orders will be processed and shipped by March 15, 2024.
Seeds | Perennial 20 seeds per pack
$2-$4 per pack sliding scale suggested donation


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Seeds | Woody Plants | Trees | Shrubs
20 seeds per pack
$2-$4 per pack sliding scale suggested donation
Live Plant Cuttings | $10-20 for Bundle of 10


Note: seeds & live plant cuttings are currently only available for preorder and will be ready to ship in early spring.
HONEY. List Quantity in "Other"
HYDROSOL. List Quantity in "Other"
DRIED HERBS. See our website for the list of available herbs and list your selections here, along with the quantity (2 oz, 4 oz, 8 oz, 16 oz).
Yearly Zine Subscription | $10-100 / access to past recipe zines
Seasonal Recipes | Practices | Teachings
Shipping or Pick Up *
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