Mountain Woman Medicine Consultation Questionnaire
Mountain Woman Medicine‘s relationship building for Wholistic Consulting Services & Build Your Own Apothecary Mojucine orders.  

This is designed to clarify the relationship between MWM/Nemeton & YOU, to help each other know what can be expected of the other and to help support understanding and direct communication. To help clarify what I Can support you with and what I can not. 

My support comes from the perspective that our bodies benefit from cyclical support/nourishment and being nudged into alignment when recognized that they are out of alignment. 
Each persons Experience of Wellness will be different, no one size fits all here. 

Once we we are aware of an imbalance we can gather information and then make an informed decision on how we want to go about supporting. A holistic Wellness approach includes looking at diet and nutrition, mental, emotional & energetic shifts and along with lifestyle adjustments. There is this wonderful growing interest of individuals that wish to take greater responsibility for their own health care and general well-being. This is what I wish to support.

My work as a InnerCartographer, Herbalist & Holistic Resource & is about supporting the empowerment of people to make wise self-care choices from a place of being well informed. I honor each person’s choice of choosing to embrace holistic health and work to assist that desire to work with alternative methods prior or in conjunction with the offerings of the medical establishment.

I am a researcher, educator and herbal practitioner & mojucine maker. My goal is to educate, provide resources, and encourage individuals to embrace responsibility for their own health. To encourage them to ask questions, to understand their own bodies and their own cycles, and to begin to identify what exists around them that might help them meet their goal.

By filling out this form and working with me, you acknowledge my limitations, and agree to take responsibility for your own health care choices, assuming the risk involved in any of those choices that you make. My goal is to educate you as best as I am able to, please use that information responsibly.

Just because it’s a natural, an herbal product, or different perspective doesn't mean it is safe, or without risk. There is also no guarantee that herbal or holistic products or shifts in perspective will produce the desired effects. Please make all your health choices educated conscious ones.

                           ***I believe in Clearly Negotiating Expectations***                        

How I can help you:

  • I can offer in-depth consultations on Holistic Wellness and offer strategies where needed.
  • I can look at data/labs you provide and offer a holistic interpretation.
  • I can give an opinion, make an educated calculation or give you a intuitive response/answer. - I can provide consultation to aid YOU in making educated decisions about achieving YOUR personal goals for health and wellness.
  • I can tell you what I might do if this was my body, mind or emotions. 
  • I can discuss shifts in perspectives, mapping tools, herbal formulas & holistic supports.
  • I can assist you in understanding your own energetic state and ways to work with it yourself.
What I can’t help with:
  • I can’t promise you any trick or remedy will accomplish what you are hoping to do. 
  • I can’t diagnose a medical condition
What is expected from You:
  • Honesty        
  • When you provide a health history you agree to give the full picture - including and not limited to past medical/surgical/psychological history, medication list, allergies and healthcare practitioners that you are currently working with.  
  • An earnest attempt and sincere commitment towards meeting YOUR personal health goals. .
  • Personal Research. Don’t take my word for it, read and educate yourself, verify and cross reference.
  • To take care of yourself. To look out for yourself. To protect yourself. Respect yourself. - To make decisions based on good information.
  • Not to make fear based decisions.
  • To provide information about any medical conditions you may have.
What You Can Expect From Me:
  • Honesty
  • I am knowledgeable in Human Design, GeneKeys, Astrology, IChing, Emotional Bridges, Anatomy & Physiology, Microbiology, general nursing & paramedic practice, many medical conditions and treatments, women’s health and herbs, first aid treatments, local plant Materia Medica, herbal medicine making & energetic balancing. 
  • That I will do my best to answer your questions and concerns.
  • That I will admit when I don’t know an answer to a question, and offer you thoughts on ways the answers may be found.
  • A sincere desire to help, support, inspire & educate.
My Background / Education / Credentials  
Click here to read: https://mountainwomanmedicine.com/credentials/ 
 
To learn more about InnerCartography, click here: https://mountainwomanmedicine.com/what-is-innercartography/ 

Fee's are known as "Exchange” on The Mountain:
  • Consultations: My rate is $250/session.   Please pay what you can. This is due at time of offering.
    (Thank you for your support) 

  • Sliding Scale & Scholarships. If this price is currently steep for you, I also offer a sliding scale starting at $150, please pay what you can. If you have need of further support please fill out this form. https://forms.gle/5zZHnm37ToAD1oT17
  • Specific remedies may be acquired through me as well. Pricing discussed during consult, typically tinctures range around $20 per oz. Nemeton’s Wellness Collective can sometimes offer support towards the acquiring of Herbal Supplements or Build Your Own Apothecary kits.  Feel free to inquire if this is a need using the same link as above.  
  • These herbal & holistic supports are mostly WildCrafted and made On Mountain. 
*Raine is no longer a licensed medical provider. If you need these services, please do consult with a trained medical professional.
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Email *
Full Name & desired pronouns *
How did you find this opportunity?
Did anyone refer you for a session? 
(Please share so we may thank them <3)
*
What is the Main reason for this Session?
(Then scroll/click through to the Section/s that pertains to your reason and answer those questions in preparation for your session) please be aware that if you select multiple aspects it may need several sessions. 
*
Please describe what you are looking for from this session. *
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