Order Form Test Mood Healers Order FormCustomer Name(Required) First Last Email(Required) Phone(Required)Referred By (if applicable) Product Selection#1 Sample Bundle5-pack 150mg capsules ($40) 5-pack 250mg capsules ($50) 5-pack 600mg capsules ($75) 5-pc 600mg gummies ($125) 5-pc 250mg chocolates ($75) 1/8oz dried mushrooms ($100) Total $465 + 35% Discount #1 Sample Bundle ($295) Remove Selection #2 Microdose Starter25-pack 150mg capsules ($200) 25-pack 250mg capsules ($250) 20-pack 600mg capsules ($300) 12 oz specialized honey ($50) Custom Dosage Schedule ($80) Total $880 + 50% Discount #2 Microdose Starter ($440) Remove Selection #3 Mushrooms VarietyAPE 1/8oz ($100) Golden Teachers 1/8oz ($100) Phobos 1/8oz ($150) Enigma 1/8oz ($150) Angry Birds (p) 1/8oz ($165) Quique (p) 1/8oz ($250) Total $915 + 60% Discount #3 Mushrooms Variety ($395) Remove Selection #4 Mushrooms Variety + Enigma SupremeAPE 1/8oz ($100) Golden Teachers 1/8oz ($100) Phobos 1/8oz ($150) Enigma 1/8oz ($150) Angry Birds (p) 1/8oz ($165) Quique (p) 1/8oz ($250) Enigma Supreme 1/8oz ($165) Total $1080 + 60% Discount #4 Mushrooms Variety + Enigma Supreme ($495) Remove Selection #5 Mushrooms Variety + GhostAPE 1/8oz ($100) Golden Teachers 1/8oz ($100) Phobos 1/8oz ($150) Enigma 1/8oz ($150) Angry Birds (p) 1/8oz ($165) Quique (p) 1/8oz ($250) Ghost 1/8oz ($200) Total $1,114 + 60% Discount #5 Mushrooms Variety + Ghost ($495) Remove Selection #6 Mushrooms Variety + Bluey VuittonAPE 1/8oz ($100) Golden Teachers 1/8oz ($100) Phobos 1/8oz ($150) Enigma 1/8oz ($150) Angry Birds (p) 1/8oz ($165) Quique (p) 1/8oz ($250) Bluey Vuitton 1/8oz ($200) Total $1,114 + 60% Discount #6 Mushrooms Variety + Bluey Vuitton ($495) Remove Selection #7 Mushrooms Entire MenuAPE 1/8oz ($100) Golden Teachers 1/8oz ($100) Phobos 1/8oz ($150) Enigma 1/8oz ($150) Angry Birds (p) 1/8oz ($165) Quique (p) 1/8oz ($250) Enigma Supreme 1/8oz ($165) Ghost 1/8oz ($200) Bluey Vuitton 1/8oz ($200) Total $1,480 + 45% Discount #7 Mushrooms Entire Menu ($795) Remove Selection Mushroom Edibles: Gummies & ChocolatesGummies Gummies 600 mg 5-pack ($125) Gummies 600 mg 10-pack ($220) Gummies 600 mg 20-pack ($360) Gummies 600 mg 50-pack ($735) Remove Selection Gummies FlavorVariety FlavorBlueberryMangoMixed BerryPineappleWatermelonStrawberryChocolates Chocolates 150 mg 20-pc ($180) Chocolates 150 mg 40-pc ($320) Chocolates 250 mg 20-pc ($240) Chocolates 250 mg 40-pc ($400) Chocolates 350 mg 20-pc ($300) Chocolates 350 mg 40-pc ($480) Remove Selection Capsules SelectionHelpful Information: 7-pack (sample), 20-pack (4 weeks), 50-pack (10 weeks), 80-pack (16 weeks)APE Capsules (Psilocybin: 1.17%) APE 150 mg 7-pack ($100) APE 150 mg 20-pack ($150) APE 150 mg 50-pack ($250) APE 150 mg 80-pack ($350) APE 250 mg 7-pack ($125) APE 250 mg 20-pack ($200) APE 250 mg 50-pack ($350) APE 250 mg 80-pack ($500) APE 600 mg 7-pack ($150) APE 600 mg 20-pack ($300) APE 600 mg 50-pack ($550) APE 600 mg 80-pack ($800) Remove Selection APE Capsules (Psilocybin: 1.17%) (Additional if needed) APE 150 mg 7-pack ($100) APE 150 mg 20-pack ($150) APE 150 mg 50-pack ($250) APE 150 mg 80-pack ($350) APE 250 mg 7-pack ($125) APE 250 mg 20-pack ($200) APE 250 mg 50-pack ($350) APE 250 mg 80-pack ($500) APE 600 mg 7-pack ($150) APE 600 mg 20-pack ($300) APE 600 mg 50-pack ($550) APE 600 mg 80-pack ($800) Remove Selection Golden Teach Capsules (Psilocybin: 1.04%) Golden Teacher 600 mg 5-pack Capsules ($125) Golden Teacher 600 mg 7-pack Capsules ($150) Remove Selection Enigma Capsules (Psilocybin: 1.68%) Enigma 600 mg 5-pack Capsules ($175) Enigma 600 mg 7-pack Capsules ($225) Remove Selection Phobos Capsules (Psilocybin: 1.59%) Phobos 600 mg 5-pack Capsules ($175) Phobos 600 mg 7-pack Capsules ($225) Remove Selection Angry Birds Capsules (Psilocybin: 1.81%) Angry Birds 600 mg 5-pack Capsules ($190) Angry Birds 600 mg 7-pack Capsules ($245) Remove Selection Quique Capsules (Psilocybin: 2.93%) Quique 600 mg 5-pack Capsules ($275) Quique 600 mg 7-pack Capsules ($350) Remove Selection Enigma Supreme Capsules (Psilocybin: 2.67%) Enigma Supreme 600 mg 5-pack Capsules ($190) Enigma Supreme 600 mg 7-pack Capsules ($245) Remove Selection Ghost Capsules (Psilocybin: 3.23%) Ghost 600 mg 5-pack Capsules ($250) Ghost 600 mg 7-pack Capsules ($300) Remove Selection Bluey Vuitton Capsules (Psilocybin: 2.46%) Bluey Vuitton 600 mg 5-pack Capsules ($250) Bluey Vuitton 600 mg 7-pack Capsules ($300) Remove Selection Capsule Mega Packs All Mushroom Varieties + APE 600 mg 45-pack Capsules ($990) All Mushroom Varieties + APE 600 mg 63-pack Capsules ($1,170) Remove Selection Raw Mushroom SelectionHelpful Conversions: 1g = 1,000mg, 1oz = 28g, 1lb = 16ozAPE Raw Mushrooms (Psilocybin: 1.17%) 1/8 oz APE ($100) 1/4 oz APE ($160) 1/2 oz APE ($280) 1 oz APE ($490) 2 oz APE ($780) 1/4 lb APE ($1,250) 1/2 lb APE ($1,840) 1 lb APE ($2,600) Remove Selection Golden Teacher Raw Mushrooms (Psilocybin: 1.04%) 1/8 oz Golden Teacher ($100) 1/4 oz Golden Teacher ($160) 1/2 oz Golden Teacher ($280) 1 oz Golden Teacher ($490) 2 oz Golden Teacher ($780) 1/4 lb Golden Teacher ($1,250) 1/2 lb Golden Teacher ($1,840) 1 lb Golden Teacher ($2,600) Remove Selection Enigma Raw Mushrooms (Psilocybin: 1.68%) 1/8 oz Enigma ($150) 1/4 oz Enigma ($240) Remove Selection Enigma Supreme Raw Mushrooms (Psilocybin: 2.67%) 1/8 oz Enigma Supreme ($165) 1/4 oz Enigma Supreme ($265) Remove Selection Phobo Raw Mushrooms (Psilocybin: 1.59%) 1/8 oz Phobos ($150) 1/4 oz Phobos ($240) Remove Selection Angry Birds Raw Mushrooms (Psilocybin: 1.81%) 1/8 oz Angry Birds ($165) 1/4 oz Angry Birds ($265) Remove Selection Quique Raw Mushrooms (Psilocybin: 2.93%) 1/8 oz Quique ($250) 1/4 oz Quique ($375) Remove Selection Bluey Vuitton Raw Mushrooms (Psilocybin: 2.46%) 1/8 oz Bluey Vuitton ($200) 1/4 oz Bluey Vuitton ($320) Remove Selection Ghost Raw Mushrooms (Psilocybin: 3.23%) 1/8 oz Ghost ($200) 1/4 oz Ghost ($320) Remove Selection Optional ServicesMood Healer Services Sample Pack Directions ($25) Custom Dosage Schedule ($80) Herodosing Remote Monitoring ($300) Remove Selection Shipping & Payment DetailsPayment Method(Required)Debit/CCZelleApple PayCash AppPersonal CheckShippingExpress (Free)2-Day ($20)Overnight ($35)Canada/Europe ($55)Australia ($95)Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Add-On Only: Special Gummies Promo!Special 5-pack promo available with any main item. Limit 1 pack/order. Gummies 600 mg 5-pack ($50) Remove Selection Total