Doctor Dragoness Consult Questionnaire

1
Full Name* This field is required.I need the following information so that I can reach out to you directly to schedule your Acupuncture Experience, Womb Ceremony or FREE Alignment Call for Womb Mentorships.
First Name
Last Name
2
Email* This field is required.You will receive an email from Dr. Jools, reaching out to schedule your Appointment or FREE Alignment Call.
example@example.com
3
Phone Number* This field is required.Be sure to include the country code first.
Country Code
Area Code
Phone Number
4
Do you communicate on WhatsApp?Look out for a message from Dr. Jools on WhatsApp. If you don't use this app, make sure to check your email inbox.
Yes
No
5
Let me know which realm of holistic service you are seeking.* This field is required.
Acupuncture Experience {1:1 Mobile In-home service to Dominical-Uvita-Ojochal, Costa Rica}
Acupuncture Experience {1:1 service at my Oasis in Dominical, Costa Rica}
Womb Ceremony {1:1 service at my Oasis in Dominical, Costa Rica}
FREE Alignment Call {for online Womb Revel Academy/Womb Mentorship - worldwide}
FREE Alignment Call {for inquiries about Facilitating in your Wellness Retreat - worldwide}
6
In brief, please describe what is present in your life that has drawn you to seeking my services. * This field is required.If interested in the Acupuncture Experience, Womb Ceremony, or Womb Revel Academy...please discuss the state of your physical, mental/emotional & spiritual bodies. If interested in retreat facilitation, please describe your wellness retreat (offerings, location, venue, dates, group size, etc.) & your mission.
7
How did you find out about Dr. Jools Candelaria's services?* This field is required.
8
Keep an eye on your WhatsApp messages & email inbox for a message from Dr. Jools Candelaria. She will be in touch soon to confirm booking your Acupuncture Experience, Womb Ceremony or FREE Alignment Call {for Womb Mentorship or Retreat Facilitation}.

Thank you for connecting. Just click submit below & you're all set!

Website: DoctorDragoness.com // Instagram: @Doctor.Dragoness
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