A Healthy Beginning Holistic Essentials Home & Body Kit
To subscribe for A Healthy Beginning's Holistic Essentials Home & Body Kit, please complete this form.
Full Name (First and Last, as it shows up on your PayPal or EMT account, depending on how you are paying)
Email Address (as it shows up on your PayPal or EMT account, depending on how you are paying)
Prefer not to say
Your Skin Type (select all that apply)
Normal or Combination (oil is produced around the 'T-zone' of the nose and forehead but not on the cheeks, mouth and eye areas)
Oily or Acne-prone
Sensitive (e.g. have rosacea, eczema or allergies, or your skin can become inflamed and irritated easily)
Do you have any of the following skin conditions?
Your Hair Type
Are you currently pregnant and/or breastfeeding? (select all that apply)
If you are pregnant, what is your estimated due date? (this will help us determine if it is safe to include certain essential oils in your products)
Are you interested in products for pregnant and/or breastfeeding women? (select all that apply)
Yes, I am interested in products for pregnant women
Yes, I am interested in products for breastfeeding women
If you have young children you would like to use our products for, how old are your children?
1-2 years old
3-5 years old
6-12 years old
Do you have any allergies or sensitivities to food or other ingredients we should be aware of?
Is it important to you to have only vegan ingredients in your products (i.e., no ingredients such as honey or beeswax)?
Not absolutely, but prefer to have vegan ingredients
No, it does not matter to me
What is your preferred pick-up location? NOTE: Unless alternate arrangements are made, pick-up days are the second Wednesday and Friday of each month.
1623 E.21st Avenue, 9am-9pm
401 Burrard, 9am-5pm
At any Vancouver SkyTrain station, at specific pre-determined times
Form of Payment - How will you be paying for your first 3-month subscription of $105? NOTE: A confirmation email with more details on how to pay will be sent to you once your registration has been accepted.
Any additional comments?
A copy of your responses will be emailed to the address you provided.
Please complete the captcha before submitting the form.
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