Patient / Client Application

MsHec3 Client Application Form

MsHec3 Client Application Form

Employed: *
Military: *
Retired: *
On Disability: *
Are you looking for assistance with: (check all that apply)

Discount criteria is based on income plus dependents.

80% discount – Income at $15k or less per dependent.
60% discount – Income at $16-25k or less per dependent.
40% discount – Income at $26-30k or less per dependent.
20% discount – Income at $31-40k or less per dependent.


Click on link below for a printable copy of the Application form that you can fill out and mail to Mountain Spirit Healing and Education Center
MsHEC3 Practitioner Application

MsHEC3 Practitioner ApplicationĀ 
If you live in our community and need assistance with healing for your Physical, Emotional, Mental or Spiritual Health. Or if you seek education for self empowerment, please complete the Client Application below. We offer scholarships that gift up to 80% of the price of a session or class with our practitioners and teachers. Return your application to or drop it off in person at Mountain Spirit Co-Op. One of our board members will contact you right away to schedule an intake. Please note, you must provide proof of income to request a scholarship.

If you have any questions please feel free to call (928) 421-3399 or email us at

PO. Box 11553
Prescott, AZ 86304

(928) 421-3399~MsHec3

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