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Wellness Gram Request Form
Your name
Your email
What is the name of the individual you would like to have receive a gift box?
How are you associated with this person?
Street Address of Receiver (if known)
Please provide the best phone or email for the receiver. (We will use this to reach out and confirm their shipping details).
To the best of your knowledge, does the recipient have any experience with cannabis?
Share a personal message with the receiver and let them know what makes them special! (Your message will be included inside their box.)
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Email
SUBMIT
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