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Contact
Poetry Nights at Root3d
The Collective
JOIN THE FAMILY
Healers
Initiatives Team
BIPOC Healer Database
The Companies at Legacy
Offerings
Classes + Workshops
One On One Sessions
Community Engagement
Root3d Apothecary + Handmade
Pre-recorded Offerings
Root3d Writings
Donate to Root3d
Event Space Rental
Contact
Poetry Nights at Root3d
One On One Sessions
Pay For My One On One Session
Pay Now
Book My Consultation
Root3d Healers are available for virtual or in-person sessions
Name
*
First Name
Last Name
What are your pronouns?
They/ Them
She/ Her
He/ Him
Other
Email
*
Phone
(###)
###
####
What kind of session are you interested in?
Non-Clinical Talk Therapy
Reiki
Tarot Reading
Intuitive Eating/ Health Coach
Thai Bodywork
Pregnancy/ Birth/ Postpartum Doula
Bereavement Doula
Herbalism
Mother/ Father Wound Healing
Hypnotherapy
Yoga/ Stretch
Chakra Balancing
Life Coaching
Addiction Support
Other
Do you have a specific healer in mind that you'd like to work with?
Do you have any preferences for the race, ethnicity, gender, or sexual orientation of your healer?
Do you have any layers of your identity that you would like to be affirmed by your healer?
Trans affirming
Kink affriming
Poly affirming
LGBTQIA+ affriming
BIPOC affirming
Sapient Being (45yrs +)
Trauma Informed
I will specify below
Do you have any specific intentions you're hopeful for in your sessions?
Do you have previous experience with the healing modality you're interested in now?
"I am feeling balanced, healthy, and well"
Emotionally
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Spiritually
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Physically
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Do you currently engage in any personal wellness rituals? (i.e. meditation, prayer, exercise)
Thank you!
