Food Sensitivity Payment Page

Food Sensitivity Test Payment Form

Name*
First Last
Email*
Phone*
Date of Birth*

MM/DD/YYYY
Mailing Address (for test kit)*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Food Sensitivity Testing + Consultations*
Price:
This includes the test kit that is mailed to you, your test results, information, initial consultation with Caitlin, follow-up consultations, and email access to Caitlin in between sessions.
Credit Card*