Custom Blend Request
  • With this form you are able to request a custom tea or oil blend. Please fill the form out accurately and completely. 
  • Blends can take anywhere from 48 hours to two weeks to complete and will then be shipped to you directly. Orders are made as requested and will require payment before process is started. 
  • We will contact you when your request is received
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Email *
Full Name *
Phone *
Purpose for blend *
Required
If other, please explain
What type of blend are you requesting? *
If you chose oil, will this be used for Internal or External use.
Clear selection
How much product do you wish to receive? *
Please Select Your Desired Herbs *
Required
For Infused Oils Only - Choose your oil to be infused
Additional Comments
I agree and acknowledge that by submitting this request for a custom blend for use of tea, oil or salve, that Restored Roots LLC is not liable for any adverse reactions, health issues, or consequences resulting from my custom product request. I understand Restored Roots LLC has the right to refuse or modify any submitted blend at its discretion, based on factors including but not limited to ingredient availability, quality standards or other concerns.
 *
Required
A copy of your responses will be emailed to the address you provided.
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