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Name*

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Purpose of Consultation*

I need more information about Earth Energy Connection sessions.

I'm ready to choose a Nature guide & finalize my session details.

List 2 good days & times for a 10-15 min. phone chat (in your time zone.)

List your City, State, Zip code*

Best Contact Phone Number*

Have you received energy work before?*

No, this would be my first time.

Yes, however only in person.

Yes, in person and/or long distance.

Why are you interested in an Earth Energy Connection session at this time?*

You'll be added to my email list for news & promotions regarding this business. Your information is kept private, for GreenSpirit Crat use only. You're welcome to Unsubscribe at any time. Do I have your permission? *

Yes, that's fine.

No, I have concerns, which I'll add in the notes below.

Something else you'd like me to know?

707*582*0894

Katrina@GreenSpiritCraft.com

1275 4th St. PMB 6006

Santa Rosa, CA 95404

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