Informed Consent Form
Thank you for your interest in being part of our community! You are invited to try a new supplement designed to support intimacy. This is not medication, just an expertly formulated herbal and nutritional supplement to gently support libido and body confidence.

We ask that you read through the expectations below and issue your signature by typing your name, indicating that you consent to involvement in this sample group. Please reach out to Elizabeth Permenter at 917-903-9343 or egpermenter@gmail.com with any questions.

Please reference our FAQ for additional details on formulation, ingredients, and instructions for use here: https://bigliz.biz/catnip/faq 

What to Expect

  • You will receive a free initial sample package 

  • We are reliant on consistent pulses of feedback from testers which will include:

    • Online or in-person group forums to share reflections and support 

    • Digital form completion (just 3 questions in 30 seconds) 2 weeks after sample delivery, and again 2 weeks later

  • There will be no medical supervision; this is a wellness and feedback-based experience, not a clinical trial

Sign in to Google to save your progress. Learn more
Email *
Phone Number *
Mailing address for sample *

I understand that my involvement in this sample group is completely voluntary. I can stop using the supplement(s) or withdraw from the group at any time, no explanation required.

I understand that these supplements are non-hormonal and made from widely used, food-grade ingredients. I also understand that every body is different, and I agree to: 1) Stop using the supplements immediately if I experience any discomfort, allergic reaction, or anything concerning; 2) Speak with my healthcare provider if I have any doubts about whether these products are right for me.

I understand that participation is strongly discouraged for breastfeeding or pregnant women.

I know that any personal information or feedback I share will be kept confidential. Anonymous quotes may be used to help tell the story of this work and its impact.

By typing my name below, I confirm that:

I understand this is not a medical study.

I accept full responsibility for my decision to try the supplement(s).

I’m open to providing honest feedback and participating in a supportive, non-judgmental community.

 *
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms