Direct Order Inquiry

Name*

First Last

Company Name

Job Title

Email*

What is your phone number?*

What type of customer are you?*

How many plants per year do you grow?*

Please enter a value between 1 and 10000000.

How do you grow? - DEPRECATED*

What is your licensing status?*

What style of growing do you do? (select all that apply)

What types of clones are you interested in? (select all that apply)*

How many patients or customers do you have?

Please enter a value between 1 and 10000.

How many patients do you see per day?*

Do you have a clone department?*

What is max amount of clones allowed for purchase per member/per day?*

Please enter a value between 1 and 10000.

Do you have an easily accessible parking lot for our delivery vans?

Retail Location*

Street Address City State ZIP Code

Would you be willing to pay a delivery fee?

Who referred you to DHN?

In which county are you primarily located?*

How frequently do you purchase clones? - HIDDEN

What would be the average number of stems you'd need in a single clone order?

Please enter a value between 1 and 50000.

What topics would you like to see more information on? (select all that apply)

What purpose are you growing for?

When do you typically purchase your clones? (select all that apply)

What strain categories most interests you? (select all that apply)

What strains are you most interested in? (select all that apply)

Are there any comments or feedback you would like to share with us? If so, tell us here.

Age Verification*

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