Gentle Healing After Loss

Please complete the form below to schedule your FREE Gentle Reconnection Session. Your information will be held in confidence and used only for scheduling and support purposes.

First Name *

Last Name *

Phone *

Email *

Date of birth *

Have you experienced (please choose what feels right)...

Pregnancy Loss

Infant Loss

Other

How far along were you? (only if you feel comfortable sharing)...

Would you like to share anything about your experience or how you're feeling physically or emotionally? (Feel free to share as little or as much as you'd like)

How would you prefer your sessions take place?

In-Person (at MBF Studio)

In-Person (at your home)

Online (Zoom)

Is there anything else you'd like for me to know before we meet? (This could include: emotional triggers, spiritual preferences, or anything that helps me to support you best, etc...)

By checking this box, I consent to receive transactional messages related to my account, orders, or services I have requested. These messages may include appointment reminders, order confirmations, and account notifications among others. Message frequency may vary. Message & Data rates may apply.Reply HELP for help or STOP to opt-out.

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