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Your uninhibited guide to all things wild & delicious
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Meet Rose
Home
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Photos
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Contact
Spoil Me
Contact Me
Please complete the screening form below to schedule with me.
Name
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First Name
Last Name
Email
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Phone
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Message
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Include date, time, and length of appointment you are requesting.
Screening
*
You must select AT LEAST ONE of the screening methods listed below. Bookings that do not include one form of screening will be deleted.
Provider Reference
LinkedIn or Facebook
Personal/Work Website
Photo ID
Provider Reference
Please include their contact information and link to their website or advertisement.
LinkedIn or Facebook profile
Personal/Work Website
This must have your name or contact information listed on the website.
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Photo ID
Please email my assistant your photo ID at msbarbaryrose@protonmail.com after completing this form.
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