Consultation | Stone House Holistics | Custom Herbal and Specialty Skincare

Custom Herbal & Specialty Skincare Consultation Form

Please note that in accordance with Health Canada's new regulations, the sale of all herbal extracts, syrups, and creams now require a consultation prior to purchase. Our complimentary consultations are conducted via phone or email for your convenience. All customers are required to fill out the form below, and we will accommodate your request to the best of our ability.

Phone consultations will be scheduled Monday to Friday between 9am and 12pm EST. Any consultation is limited to you or your own child under the age of 18 for 1 herbal inquiry only and is not intended for extended family members/third parties.

For returning customers who have already been consulted, please use the password provided at your consultation to order online.

First name

Last name

What is the main reason for this consultation?

Purchase Herbal Extracts, Syrups or Creams

Personalized Formulas

General Information

How would you prefer to be contacted?

Phone

Please indicate if you fall under these categories

Naturopathic Doctor

Herbal Medicine Practitioner

Other Natural Healthcare Provider

Briefly describe what you are looking to get support for.

Are there specific herbs or formulas you are interested in or looking for?

Do you have any underlying health conditions? If so, please list.

Are you taking any prescription medications? If so, please list.

Do you have any allergies? If so, please list.

Thank you for providing this information. I will contact you within 24-48 hours, and look forward to supporting you.

Privacy is important to me. StoneHouse Holistics® will never share your personal information without written consent to do so.