Red Boot Apothecary

1. Are you currently pregnant?

2. What is your sex?

3. Are there any known allergies or sensitivities I should be aware of?

(e.g., to specific herbs, plants, or botanicals? Example: Aster Family)

4. How would you describe your overall energy level?

• Sluggish or slow
• Wired but tired
• High and consistent
• Up and down

5. How would you best describe the "pace" of your daily life and activity?

• Grounded & Still (Sedentary): I spend a lot of time sitting or in quiet focus.
• Flowing & Steady (Moderately Active): I'm on my feet fairly often and get regular movement in.
• High-Energy & Constant (Highly Active): I am always on the go, whether it's for work, fitness, or a busy lifestyle.

6. How would you describe your general stress level?

• Constant, low level stress (e.g., a busy routine, long work hours)
• Acute, high-pressure stress (e.g., facing a big project, a major life change)
• Rarely feel stressed

7. How would you describe your sleep pattern? (Select all that apply)

• I have trouble falling asleep
• I wake up often during the night
• I wake up tired and unrefreshed
• My sleep is generally good

7a. Since you're having trouble falling asleep, would you like to add our Somnus Blend (Valerian, Passionflower, California Poppy)—designed to quiet the mind and induce rest—to your order?
1 oz bottle - $13

• Yes
• No

8. How would you describe your anxiety level?

• Rarely feel anxious
• General unease or worry
• Physical symptoms of anxiety (e.g., racing heart, shortness of breath, restlessness)
• Mentally drained by persistent anxious thoughts

9. Where do you most often feel the physical effects of stress or tension? (Select all that apply)

• Tension in my neck, shoulders, or jaw.
• Stress-related headaches or "pressure" in the head.
• Upset stomach, bloating, or digestive "knots."
• Heart palpitations or a "tight" chest feeling.
• Low back tension or a feeling of being "physically drained."
• I don't feel physical effects of stress or tension.

10. Would you like herbal support to enhance your mind-body-spirit connection (e.g., aid in focus, meditation, or inner clarity)?

• Yes, definitely.
• Maybe, but focus on my physical needs first.
• No, I only require support for energy and sleep.

11. Do you generally feel more grounded or more airy?

• Grounded (Earth): Heavy, slow digestion, tendency toward congestion/dampness.
• Airy (Air/Ether): Restless, forgetful, dry skin, trouble focusing, scattered energy.
• Balanced/Neutral

12. Is there any additional information you would like me to know that you feel is relevant to your blend?

13. Choose your supply for the journey:

• 1-Month Supply (4oz): A great way to start your ritual. $77
• The Deep Transformation (Two 4oz Bottles): 8-12 weeks of consistent nourishment. $125 — (Save $29

14. For fun, I love to see the overlap of your responses with medical astrology! What is your Sign?

• Aries (Mar 21 – Apr 19)
• Taurus (Apr 20 – May 20)
• Gemini (May 21 – June 20)
• Cancer (June 21 – July 22)
• Leo (July 23 – Aug 22)
• Virgo (Aug 23 – Sept 22)
• Libra (Sept 23 – Oct 22)
• Scorpio (Oct 23 – Nov 21)
• Sagittarius (Nov 22 – Dec 21)
• Capricorn (Dec 22 – Jan 19)
• Aquarius (Jan 20 – Feb 18)
• Pisces (Feb 19 – Mar 20)
• I'd prefer not to say

15. Would you like to join the Red Boot Apothecary newsletter?

• Yes
• No

16. Would you be comfortable with me sharing your custom blend on TikTok or social media?

• Yes, and tag my TikTok username
• Yes, anonymously
• No

15. What name would you like on the bottle?

Safety Notice: Due to the potency of herbs, I cannot formulate if you are pregnant.