First Name

Last Name

Phone *

Email *

City

Postal Code

Have you worked with Kristy before?

Yes, I've had a private reading with you

Yes, at a live event or market

No, this would be my first

Requested service

In-Depth Psychic & Mediumship Reading

Clarity Reading

The Soulful Reset

In-Person Mentoring & Coaching

How did you find Kristy, or who referred you?

Referred by a friend or client

Google search

Facebook or Instagram

Event or market

Existing client

Other

Prefer not to say

Preferred appointment time

9:15 am–10:15 am

10:15 am–11:15 am

11:15 am–12:15 pm

12:15 pm–1:15 pm

1:15 pm–2:15 pm

No preference

Preferred date (optional — Wednesday to Friday only)

Briefly explain what you are seeking support with, and include any referrer name

Relevant health, allergy or sensitivity information (required for The Soulful Reset; otherwise optional)

I confirm that I am booking this appointment for myself.

I understand that submitting this form is an appointment request and does not confirm a booking. All in-person requests are reviewed before a private booking link is provided. I understand that the exact practice address is supplied only after approval and a confirmed booking.

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