Rose Medicine Intake Form

Thanks for being here! This forms give me the contact information to add you to the private whatsapp group, and get your mailing address to receive your amazing class supplies.

Name

First Name

Last Name

Mailing Address

For supplies !

Are you 21 years or older ?

Yes

Do you have experience with herbalism, plant medicine or rose?

Phone, For Whatsapp Private group

If you do not have whatsapp and want to be apart of the private group where we will be sharing stories, sending out daily journal prompts and other relevant information, please download the app. It uses your personal phone number.

Country

(###)

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What are you most looking forward to in the Rose medicine class? (optional)