REQUEST YOUR JOURNEY KIT

This form helps me gather your preferences so I can get you exactly what you need.

Please complete the short form below to request your wellness item. Once submitted, I’ll be in touch to confirm details, share guidance, and offer next steps.

If you’re unsure what’s right for you, feel free to leave a note at the bottom—I’ll connect personally.

Name

First Name

Last Name

Phone

(###)

###

####

Preferred Communication

I use Signal as my primary communication tool. It's secure, private and supportive of the nature of this work. If you're open to it, I kindly ask that we connect there.

Yes, I'm OK with contact via Signal (and will download it if I don't already have it)

Please reach out via email or text instead

JOURNEY KIT

If you're requesting a kit, please indicate your preferences or add-on's.

Just the Essentials (basic kit) | $88

Do you want to add on to the basic kit?

YES, I'd like to add on

NO, just the basic kit

Add On: Medicine | $150

Would you like your kit to include medicine? If so, please indicate which one. Use the last question on this form to elaborate on your request if needed.

Add On: Prep + Integration Call | $30 per call (bundled pricing)

Add 30 min 1:1 sessions to help you feel grounded, clear and held before and after your ceremony. Whether you're setting intentions or integrating what came through, this personal touchpoint can make all the difference. Not sure if you need this level of support now? That's OK! I can be available for a session when you're ready (at an unbundled pricing of $50 per call).

Anything else you'd like to share?

Questions, intentions, requests, concerns...let me know what's present for you.