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Distant healing booking form

Where I live in the United Kingdom it is Tuesday, 09 March, 2010 09:37 pm

Please complete the form below to book a distant healing session(s). Distant healing is charged at £20.00 per session or 5 sessions for £80.00. After submitting the form you will be transferred to the payment page.

Once I have received your form I will contact you within 24 hours to arrange a time and date for the healing.

Distant healing booking form

Very important: Please make sure that you enter your email address correctly. Sometimes people make a mistake and I cannot reply!


Your Name:
Your Email:
Your Phone:

Please fill the details of the person for whom the healing is for below.

First Name:
Last Name:
Town / City:
Country:
Age:
Gender:

What is the healing for? (Symptoms, Complaints, Problems).

How did you find this site?


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