1:1 Guided Meditation Request Form

1:1 Guided Meditation Request Form

Please provide your details and preferences to schedule your guided meditation session.
Full Name

First NameLast Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Preferred First Appointment Date and Time

MonthDayYear
Date
Hour MinutesAM/PM Option
What is your level of meditation experience?

Other
What type of meditation are you seeking?
What is calling you to receive guided meditation at this time?
What is your intention for your meditation?
Is there anything you would like to share? Trauma, experience, remembrances, etc at this time?
I will contact you once I receive your request to confirm your date and time. Payments can be made through Venmo, PayPal, Cash, or Credit Card after we confirm dates and times together. Payment plans are also available upon request for the class packs and chakra series.
Should be Empty: