Crystal Personal Shopping Preference Form

CRYSTAL SHOPPING PREFERENCE SHEET

Please fill out this form completely for the optimal personal shopping experience 🛍️
Name*

First NameLast Name
What is your Instagram or TikTok handle? This ensures accurate identification of customer for DM and invoicing purposes. (Social media or text messaging is the fastest form of communication, but if you do not have one, then put “none” and make sure to add your email address in the next box. )
Email*
example@example.com
Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Country CodeArea CodePhone Number
Curating a selection of crystals that you will love requires open communication. This ensures the best personal shopping experience. Part of this process requires sending photos/videos of available or suggested items. Do you prefer to be contacted via text message, video call appointment, or social media messaging?*

Text my cellInstagram message meTikTok message meVideo call is best
Do you have specific chakras that you would like to work on or connect with? Please check all that apply so we can curate a list and source the crystals that would be most beneficial to you.

Stellar Gateway Chakra (above the Soul Star -Cosmic consciousness, divine source energy, interdimensional connection.)Soul Star (above the head- Connection to soul purpose, past-life wisdom, spiritual ascension.)Causal Chakra (above the Crown, slightly behind the head- Higher consciousness, access to Akashic records, divine feminine energy.)Crown (top of head- Divine connection, enlightenment, higher consciousness.)Third Eye (center of forehead/between the brows- Intuition, wisdom, inner vision, and psychic center)Throat (center of neck/throat- communication, self-expression, truth.)Higher Heart Chakra (Thymus Chakra: Between Heart & Throat- Unconditional love, compassion, deep emotional healing.)Heart (center of chest-love, compassion, connection, empathy & understanding)Solar Chakra (Between Solar Plexus & Heart -Higher self-empowerment, spiritual energy, transformation.)Solar Plexus (bottom of sternum/top of stomach- confidence, willpower, personal power, & manifestation)Naval/Hara Chakra (just below the navel- Physical vitality, chi energy, manifestation power.)Sacral (lower belly/ pelvic area/between the hips- Creativity, emotions, sensuality.)Root (lower pelvic area/sacrum- Stability, survival instincts, sense of grounding & security)Earth Star (below the feet- Grounding, connection to Earth’s energy, ancestral healing.)Gaia Gateway Chakra (below the Earth Star- Deep connection to the Earth’s core, planetary consciousness, nature wisdom.)Palm Chakras (center of hands- Healing abilities, energy transfer, working with crystals.)Foot Chakras (center of feet- Energy grounding, absorbing Earth’s healing vibrations.)Any and all chakrasNo preference
Do you have specific crystals you are searching for? If so, please list the names of those crystals in order of most sought after to least. (Please separate the crystal names with a comma.)
List crystals you are desiring.
Any struggles, goals, or topics you are trying to focus on/explore/enhance/alleviate with the use of crystals? If you prefer to leave this section blank, then check ‘prefer not to say’.

AnxietySadness/ Grief/ DepressionTrauma HealingPast Life RecallMother WoundsFather WoundsSelf Doubt / Limiting BeliefsDivine Feminine EnergyDivine Masculine EnergyBalancing the Feminine/MasculineStarseed knowledge, Ancient lost knowledge or the Akashic RecordsShadow WorkWomb WorkReiki / energy healing practiceMatters of the HeartSelf love & compassionHealing past emotional woundsMotivationManifestationQuantum LeapingHigher Self ConnectionConnecting with Higher BeingsSpirit Guide / Angel / Ancestor communicationAstral Travel / Lucid DreamingGrounding / connecting to the Earth’s energyConnecting to natureAbundance & prosperityPrefer not to say / unsureOther
Do you have crystal shape/style preferences? If so please check all that apply.

Clusters/ SpecimensTowers & PointsFreeformsFlamesSpheresEggsRough / Raw PiecesHeartsCarvingsPalmstonesJewelry -all typesBraceletsNecklacesRingsWandsBowls /plates/ jewelry dishes/ etcDecor / large statement decorationsOpen to all options! Show me a variety!Other
Do you have any health aliments that you are wishing to utilize crystals during your healing? (Please note this is not medical advice & we are not medical doctors. This is simply advice and suggestions based on ancient knowledge and practices and more holistic healing methods when it comes to the healing properties crystals are believed to have.)
Please list any health ailments you would like to share above separated by a comma. You may skip this section if you like.
What size crystals do you prefer?

MinisMediumLarge Statement PiecesOpen to all sizesOther
What color(s) of crystals do you prefer? If there is no preference type ‘any’.
Color preferences
Describe the important features that you look for in crystals you tend to purchase, if you have any?
What is your estimated total budget?
How do you prefer to be invoiced? *
If you prefer to be invoiced via Venmo through our business please provide your Venmo handle so we may request payment for your crystal invoice.
Venmo username
This section is for any additional notes that you would like to add.
Notes
By checking the box below you agree and understand that any crystals that are sourced for specifically to my needs and you have committed to claiming you must purchase by paying your invoice in full unless a payment agreement has been made with the owner or representative of Bodhi & Soul Co. prior. Payment arrangements can only be made for purchase totals of $350 or more and must be approved prior to claiming/purchasing items. For payment arrangement details please contact us via email or private message on social media (We are on IG & TikTok - @bodhisoulco ).
Please check here to show you agree to the terms of the above statement.*

Yes, I understand and agree to the above statement.
Signature*

Powered by Jotform SignClear
Should be Empty:

CRYSTAL SHOPPING PREFERENCE SHEET