What address would you like your HTMA packet sent to? 

{Alex's team sends out packets once per week, usually on Fridays}

What are your main symptoms you would hope to address through mineral assessment and balancing? 

If you could snap your fingers and have what you want for you life and health in 6 months, what would that look like? 

What other things have you tried to resolve your symptoms or reach your goals? [other practitioners, courses, electrolytes, supplements, etc]

Do you have any allergies or diagnoses Alex needs to be aware of? I.e. gluten, hypothyroid, kidney issues etc  

Please list out common foods/meals you eat. For example: breakfast - 2 slices wheat toast, 1 egg, and coffee with milk 

Please list out the average times of your meals and snacks. For example: breakfast at 10 AM, lunch at 2 PM etc 

Please list out beverages you drink daily with ounces and timing. For example: 60 oz of water throughout the day with an LMNT packet, 2 cups of coffee by 10 AM, a few oz of orange juice in the afternoon

What birth control have you been on (if any) and for how long were you on each method? This includes IUD, arm implants, pills etc. 

Are you pregnant, breastfeeding or planning to become pregnant in the next 6 months? Custom blends can be curated to be pregnancy and breastfeeding safe!

Are you currently or have you ever been vegan or vegetarian?

Please list all supplements, electrolytes and medications you are taking, including dosage and how long you have been taking them. 

Do you have copper or lead pipes in your residence? 

Anything else you want Alex to know?