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Complete this form to purchase the DUTCH Hormone Test Package with Colleen from Green Collean!

The Hormone Test Package includes:
- DUTCH hormone test (complete at home)
- 1-hour results review call (via Zoom)
- results interpretation
- personalized nutrition, lifestyle, & supplement protocol
- relevant informational handouts + charts

How it works:
1. Complete this form.
2. Colleen will contact appropriate candidates & send a purchase link.
3. Complete the hormone test (4 urine sample collections) and send them in.
4. Reach out to Colleen when your results return to schedule your 1-hour appointment.

The DUTCH hormone test is an at-home comprehensive hormone test that measures your sex hormones, adrenal (stress) hormones, and nutrition & mood chemical markers. In addition to hormone levels we also take a look at breakdown products of metabolism (metabolites), which give us more information about potential imbalances. Instead of just know WHAT is out of balance, these markers give us some insights as to WHY.

- estrogen & metabolites
- progesterone & metabolites
- androgens & metabolites
- cortisol & metabolites
- free cortisol & cortisone patterns
- melatonin
- mood chemical markers: dopamine & norepinephrine / epinephrine
- nutritional markers: vitamin B12, vitamin B6, glutathione

Package price: $454 payment – comprised of $299 DUTCH test ($100 off) + $155 1-hour consultation review call

Q - Is there a specific day I need to complete the test?
A - Yes, ideally 5-7 days after ovulation.

Q - Can I complete the test if I am on hormonal birth control?
A - If you are on hormonal birth control I do not recommend this test as your contraceptive suppresses your natural hormone production and will not give you an accurate read on your hormone levels.

Q - What about the non-hormonal copper IUD?
A - Yes, you can complete the DUTCH test if you have the copper IUD.

Q - I just stopped birth control, can I take this test?
A - I recommend waiting at least 3 months post-birth control to complete hormone testing.

Q - How is this different than a blood test with my doctor?
A - The DUTCH test includes hormone metabolites, which gives us more information into what I call "your hormone story". We take a look at your hormone levels that would correlate with blood testing and tell us WHAT is out of range, but these metabolites give us more insights about why and how your body is metabolizing your hormones.

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* 1. Full Name

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* 2. E-mail

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* 3. Instagram Handle

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* 4. Have you ever taken hormonal birth control?

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* 5. Tell me about your hormone health journey up until now.

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* 6. How many days is a typical menstrual cycle for you? (normal range= 25-35 days)

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* 7. Mark the symptoms that you are experiencing.

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* 8. On a scale of 1-10, how would you rate your daily stress levels?

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i We adjusted the number you entered based on the slider’s scale.

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* 9. What are the areas you are in most need of support with?

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* 10. What is your priority / top goal in working with me?

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