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About
Mentorship
Circle UP
- FREE Community Event
DIY
Blog
Podcasts
Resources
- Sacred Products
Contact

About
Mentorship
Circle UP
- FREE Community Event
DIY
Blog
Podcasts
Resources
- Sacred Products
Contact

Mystic Mentorship Interest Form

Shamanic Astrologer, Earth Medicine Practitioner and Mystic Mentor

Thank you for your interest in Mystic Mentorship! Please fill out the form below and I’ll get back to you within 24-72 hours to schedule your free consultation. I look forward to speaking with you soon.

Name *

First

Last

Email *

Phone Number (is text ok?)

Birth Date/Time/Place

What area of life are you most focused on at this time? (choose one)

My Personal/Individual Self
My Relationships & Partnerships
My Home/Private Self
My Work/Public Self

I want to work on ... (choose one)

Issues with my Past
Issues with my Present
Issues with my Future

I want to work on ... (choose one)

Healing
Learning
Transforming

Describe what you would like to work on in next 90-days.

What was your intuitive *confirmation* for working with Kelly?

Do you have any Additional Comments or Questions for Kelly?

Name

© 2024 Kelly M Beard | Shamanic Astrologer, Earth Medicine Practitioner and Mystic Mentor