Custom Order Request
After you fill out this order request, we will contact you to go over details and availability before the order is completed. Please note that payment must be made before we begin sourcing crystals. Any additional questions you may have please contact us at
Are you a new or existing client?
I am a new client
I am an existing client
What is the item you would like to order?
Please select all that apply
Crystal Bead Bracelet
Custom Crystal Kit
What type of crystal(s) would you like to request?
"I would like Clear Quartz, etc."
Crystal Necklace Chain or Earrings Color
Choose your preferred necklace color
Crystal Necklace Chain Length
Choose your preferred chain length
Crystal Bead Bracelet Size
Please write your wrist size below
Preferred contact method
Questions and comments
A copy of your responses will be emailed to the address you provided.
Never submit passwords through Google Forms.
This form was created inside of Universoul Crystals.