What is your age or what age are you choosing for?(Required)

<3 - Does your baby have trouble falling asleep?(Required)

(Eg: sleepness, unsettled or restless babies)

Yes
No

<3 - Do you want to soothe your baby with a loving massage with relaxing aromas that will send them off to sleep using a beautiful nourishing blend of the highest quality oils?(Required)

Yes
No

<3 - Do you want to create a haven in your baby's bedroom infused with peace, comfort, calm and tranquility using a blend of the highest quality organic essential oil spray?(Required)

Yes
No

(3-8) Does your child have trouble falling asleep?(Required)

(Eg: struggling to sleep, having mind chatter or worries affecting sleep, having nightmares or night terrors)

Yes
No

(3-8) Does your child have trouble staying asleep?(Required)

(Eg: easy to wake up or light sleep through the night, wake up early or unfreshed)

Yes
No

(3-8) Do you want support to strengthen your child's immnue system?(Required)

Yes
No

(3-8) Does your child experience daytime stress, fatigue or mood imbalance?(Required)

Yes
No

(3-8) Do you want to create a haven in your child's bedroom infused with peace, comfort, calm and tranquility using a blend of the highest quality organic essential oil spray?(Required)

Yes
No

(9-11) Does your child have stress or anxiety issue which is affecting his/her overall sleep?(Required)

(Eg: Exams, competitions, bullying or poor mental health, life changes, illness or injury and other teen pressures)

Yes
No

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(9-11) Does your child have trouble falling asleep?(Required)

(Eg: struggling to sleep, having mind chatter or worries affecting sleep, having nightmares or night terrors)

Yes
No

(9-11) Does your child have trouble falling asleep?(Required)

(Eg: struggling to sleep, having mind chatter or worries affecting sleep, having nightmares or night terrors)

Yes
No

(9-11) Does your child have trouble staying asleep?(Required)

(Eg: easy to wake up or light sleep through the night, wake up early or unfreshed)

Yes
No

(9-11) Do you want support to strengthen your child's immune system?(Required)

Yes
No

This field is hidden when viewing the form

(9-11) Do you want support to strengthen your child's immune system?(Required)

Yes
No

(9-11) Does your child experience daytime stress, fatigue or mood imbalance?(Required)

Yes
No

(9-11) Do you want to create a haven in your child's bedroom infused with peace, comfort, calm and tranquility using a blend of the highest quality organic essential oil spray?(Required)

Yes
No

(12-19) Do you or your child have stress or anxiety issue which is affecting the overall sleep?(Required)

(Eg: Exams, competitions, bullying or poor mental health, life changes, illness or injury and other teen pressures)

Yes
No

(12-19) Do you or your child have trouble falling asleep?(Required)

(Eg: feeling hard to switch off a busy or worried mind, needing resetting sleep patterns)

Yes
No

(12-19) Do you or your child have trouble staying asleep?(Required)

(Eg: easy to wake up or light sleep through the night, wake up early or unfreshed)

Yes
No

(12-19) Do you want support to strengthen your or your child's immnue system?(Required)

Yes
No

(12-19) Do you or your child experience daytime stress, fatigue or mood imbalance?(Required)

Yes
No

(12-19) Do you want to create a haven in your or your child's bedroom infused with peace, comfort, calm and tranquility using a blend of the highest quality organic essential oil spray?(Required)

Yes
No

45+ What is your gender?(Required)

Women
Men
Not listed / Prefer not to answer

45+ Do you have trouble falling asleep or falling back to sleep after waking up?(Required)

Yes
No

45+ Which do you think is the cause of your sleepless?(Required)

Feeling hard to switch off a busy or worried mind, needing resetting sleep patterns)
Peri-menopause or menopause related (menopausal symptoms such as flushing, night sweats)
Both of them

45+ Which do you think is the cause of your sleepless?(Required)

Feeling hard to switch off a busy or worried mind, needing resetting sleep patterns)
Experiencing sleep disruption due to waking in the night to visit the bathroom
Both of them

45+ Which do you think is the cause of your sleepless?(Required)

1. Feeling hard to switch off a busy or worried mind, needing resetting sleep patterns)
2. Peri-menopause or menopause related (menopausal symptoms such as flushing, night sweats)
3. Experiencing sleep disruption due to waking in the night to visit the bathroom(Prostate related)
Both 1+2
Both 1+3

(20-44) Do you have trouble falling asleep?(Required)

(Eg: feeling hard to switch off a busy or worried mind, needing resetting sleep patterns)

Yes
No

(20-44) Do you have trouble staying asleep?(Required)

(Eg: easy to wake up or light sleep through the night, wake up early or unfreshed)

Yes
No

(20-44) Do you want support to strengthen your immune system?(Required)

Yes
No

(20-44) Do you experience daytime stress, fatigue or mood imbalance??(Required)

Yes
No

(20-44) Do you want to create a haven in your bedroom infused with peace, comfort, calm and tranquility using a blend of the highest quality organic essential oil spray?(Required)

Yes
No

45+ Do you have trouble staying asleep?(Required)

(Eg: easy to wake up or light sleep through the night, wake up early or unfreshed)

Yes
No

45+ Are you often waking up at night to go to the toilet? (Men)(Required)

(More than 1 time/night?)

Yes
No

45+ Are you often waking up at night to go to the toilet? (Gender Not listed / Prefer not to answer)(Required)

(More than 1 time/night and may be related to Prostate function))

Yes
No

45+ Do you want support to strengthen your immnue system?(Required)

Yes
No

45+ Do you experience daytime stress, fatigue or mood imbalance?(Required)

Yes
No

45+ Do you want to create a haven in your bedroom infused with peace, comfort, calm and tranquility using a blend of the highest quality organic essential oil spray?(Required)

Yes
No

Phone

This field is for validation purposes and should be left unchanged.

Sleep & Stress Solution Questionnaire

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