Name/s :
Birthdate/s :
General Appearance (Hair colour and length, eye colour) :
Contact Details :
Occupation (if relevant) :

Preferred Mandala size : Small (20cm di),  Medium (28cm di),  Large (40cm di)

Colours (at least 4 with description- soft, earthy, bright etc):


Shapes (square, oval, curvy, circles, spirals, stars, hexagons, etc):


Spiritual beliefs (meditation, dreams, religion, astrology, love of nature, shamanism,  etc):


Aims - where you would like to aim toward in life for general happiness and wellbeing :


Icons, symbols or mythological creatures you relate to (fairies, dragons, unicorns, angels, etc):


Natural elements that you resonate the most with ( please choose 1 or more)
EARTH- practical, solid, determined, secure, quiet strength, patience, organised
AIR- mentally active, agile, quick witted, curious, interested, social, communicative
FIRE- spontaneous, active, creative, strong, independent, larger then life
WATER- emotional, inspired, intuitive, dreamy, intense, profound


Landscape elements that you feel connected to or energised by ( eg mountains, trees, flowers, the sea, deserts, forests, rivers, stars, moon, sun etc):



Animals that you feel connected with or that you would like to draw inspiration from in some way :


Cultural interests (countries, cultures etc):


Hobbies, loves :


Partners, family, friends that you would like included in some way :


Any other details that you may feel as relevant :


(Please feel free to add any photos of family, animals or landscapes if necessary )



If you are interested in having a personal mandala created  please copy the mandala form, fill out all details and  email to me. If you have any other questions please include it in your mail.
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