Consultation | StoneHouse 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.

To receive a complimentary 15-20 minute micro-consultation by telephone:

Please call 1 (705)-652-5005

Between Mon-Fri - 9 a.m. - 12 noon EST

*I do not schedule telephone call appointments.

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. Canadian residents only.

For returning customers who have already been consulted, please use the password provided at your consultation to order online. You agree to keeping this password confidential & not sharing with others - it is for your personal access only.

First name

Last name

What is the main reason for this consultation?

Purchase Custom Herbal Extracts, Syrups / Creams with zero chemical allergens, synthetic or artificial color/dye ingredients

Personalized Formulas

General Information

Do you wish to be contacted by email OR do you wish to connect with us by phone using the information below?

Phone

Complimentary 20-30 min. micro-consultation by telephone. Please do fill out consultation form prior to calling us.

Please call 705 652 5005 Monday to Friday, between 9 a.m. - 12 noon EST.

This is the window of my availability for receiving calls.

*I do not schedule telephone call appointments.

Canadian residents only.

Kindly do not call when driving as you need to be able to take notes while on our call at your end.

Phone

Please indicate if you fall under these categories

Naturopathic Doctor

Herbal Medicine Practitioner

Other Natural Healthcare Provider

Briefly describe the main concern you are looking to get support for.

Are there specific herbals 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 food allergies or any religious dietary restirctions? If so, please list.

*Thank you for providing this information. If you have requested an email response, I will contact you by email within 24-48 hours, and look forward to supporting you.

Privacy is important to StoneHouse Holistics®. This information taken is not shared with any outside agencies nor is any of your information shared with Health Canada for any reason.