CONTACT

Looking for some more information? Fill out our contact form below and we will reach out to you as soon as possible.

Supplement Order

All out of your supplement or will be out of it soon? Fill out this form to let us know what you’re looking for so we can have it in stock for you when you need it. We will let you know once your supplement arrives at the clinic.

mushroom supplement bottles lying next to pieces of bark and dried mushrooms

Name

First Name

Last Name

Phone

(###)

###

####

Brand Name

Formula Name

Please include supplement formula name.

Quantity

How many bottles do you need?

Additional Notes for Provider

We’re located across from Eagan Central Park Commons and near the intersection of Yankee Doodle and Pilot Knob Road. We are the first door on the left in Suite 102 when you enter the building.

Call or Text: 651-338-3574
Fax: 651-683-2906

Yankee Square III Building
3460 Washington Drive, Suite 102
Eagan, MN 55122

Email: info.lifestreamwellness@gmail.com