Customized Wellness Protocol Recommendation 
 Please answer the questions below and I will send you a customized wellness protocol.  
What specific health concerns are you wanting to address?*
In the past 12 months, which of the following symptoms have you experienced? (Check all that apply.)
Which of the following BEST describes your current nutrition?
Are you currently on any medications or have you taken any prescription medications in the previous years? (Including hormonal birth control.
Anything else you believe would be important to know?
What is the best way for me to contact you with your wellness protocol?
If Facebook/Instagram is your preferred use of communication drop your URL here.

Copyright Michelle Haman 
Haman's Homestead LLC 
Dunlap, TN 37327