What area of wellness would you like to improve most:

I am struggling most with OR want to improve the following area the most: *

Athletic Performance

Focus

Pain/Inflamation

Sleep

Stress/Anxiety

Skin Health

Reduce Cravings/Burn Calories

Your Focus

I know you have many facets in your life, but what is most pressing right now?

I would describe myself as: *

I am an athlete looking to enhance my Performance

I am more interested in everyday wellness

I would like a natural approach to pain management

I struggle with or want to improve my sleep

Describe how you'd like to improve your sleep.

I am looking for help in the following areas (check all that apply):

I wake up throughout the night

I have a hard time going to sleep

I have a hard time staying asleep

I don't wake up rested

Full Name

Email *

Phone (optional but helpful)

I agree to that by providing my information I will receive messages from Stephanie about wellness tips and the super patch.