Name
*
First Name
Last Name
Email
*
Gift Recipient
If this is a gift, please include the name of the recipient.
First Name
Last Name
Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Time of Day
*
What time of day would you prefer to drink your tea?
Energy Level
*
Would you like your tea to include caffeine?
Tea Base
*
What kind of tea do you enjoy most?
Flavor Profile
*
What flavor(s) would you enjoy in your blend? Choose up to 3.
Aversions
Are there any herbs or spices you dislike?
Requests
Are there any herbs or spices you would like included in your blend? We will do our best to include your preferences. Include up to 3.
Constitution
Do you/the recipient tend to express (you can choose more that one)...?
Temperament
Mental and Emotional Energy
Physical Energy
Stress Level
Sleep Quality
Digestion
Specific Health Conditions
Do you have any specific health concerns you would like the tea to address?
Allergies &Current Health Conditions
Do you have any allergies or health conditions we should know about?
Tea Blend Name
Your tea blend will have your name as the label (ex. "Name's" Tea). If you would like different wording on the label, please indicate your wording here...
Label Color
*
List one color.
Label Design
Choose one label design. See examples of each below the SUBMIT button.
