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Mineral Magic Intake

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Question 1 of 10

What address would you like your HTMA packet sent to? 

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

Question 2 of 10

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

Question 3 of 10

What are your goals? How would you like to feel 6 months from now? 

Question 4 of 10

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

Question 5 of 10

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. 

Question 6 of 10

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!

Question 7 of 10

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

Question 8 of 10

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

Question 9 of 10

Do you have copper or lead pipes in your residence? 

Question 10 of 10

Anything else you want Alex to know? 

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