Begin Your Journey

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STEP 1: Questionnaire

Your personal information is secure & will only be shared with our immediate review team to process your invitation.

Basic Information

Full Name

Mobile

Location

Age

Basic weight:

Medical Info

Do you currently take any supplements or prescription medication? If so, please list each one with duration of use.

Tolerance levels. What are your tolerance levels to everyday stimulants? For example, coffee, wine, caffeine, etc. What we really want to understand is how sensitive you are. High tolerance, low tolerance, etc

Low

Normal

High

Do you have any specific mental health conditions, disabilities or health complications?

What are your intentions with our nootropics?

Please provide as much information as possible as to your calling for a nootropic.

How did you hear about us?

If a friend referred you, tell us who so we can say thanks!

I am aware pricing for products begins at $175

Complete our questionnaire & schedule a 15 -minute phone consultation to complete your invitation request. And good news: this only takes a couple of minutes.

STEP 1: Questionnaire

Basic Information

Medical Info

What are your intentions with our nootropics?

How did you hear about us?

BEGIN YOUR JOURNEY

Let's get to know each other, shall we?

STEP 2: Schedule your free consultation: