Set A Consultation

A consultation is required before any RootMojo services can be administered.  The purpose of the consultation is to review your concerns and symptoms, so that a professional can provide feedback and determine which treatment options are available to you.  After you fill out and submit the consultation form, our practitioner will respond with their initial diagnosis and suggested treatment recommendations within 72 hours.  Please be complete, details are everything!  The $50 consultation fee is non-refundable.

BY SUBMITTING THE CONSULTATION FORM, YOU ACKNOWLEDGE YOU HAVE REVIEWED AND AGREE TO ACCEPT THE TERMS AND CONDITIONS OUTLINED IN OUR POLICY NOTICE.

    ROOTHEALING CONSULTATION FORM

    Patient Information
    Have you reviewed and agree to accept the terms and conditions in our POLICY NOTICE?

    First Name

    Last Name

    Email

    Phone

    Date of Birth

    Gender Identity

    Current Location
    Street Address

    Apartment/Suite/Unit

    City

    State/ Province/ Region

    Zip/ Postal Code

    Country



    Treatment Assessment Information

    Does your situation involve another person?

    Mental/physical symptoms experienced

    Current or past treatment by another practitioner?
    Yes, still under treatmentYes, in the past (finished)No

    Treatment Goals
    Type of Energy Medicine Treatment Desired

    Your Situation

    Attach a Photo

    Final notes, details, names, and requests

    Have a unique situation?

    Address your needs and wishes with the attention and detail they deserve! Our services are tailored to each patient's individual situation and performed with a full consultation, evaluation, and diagnosis. If you are reading these words, you have been drawn to the healing power of spirituality, alternative treatment modalities, and energy medicine. There is another way. Set your consultation today!

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    Degrees and Qualifications

    Wisdom is essential. Here's a short list of titles and accomplishments, past and present:

    • Holistic Practitioner, PhD
    • Life Coach
    • Specialist in Mind-Body-Spirit Medicine and treating Spiritual Disease
    • Doctorate Degree in Health Sciences
    • Public Forensic-Medical Intuitive Investigator
    • Remote Viewer
    • Spiritual Advisor
    • Energy Healer

    General Services