Enquiry Form

Fields marked with an * are required

Full Name: *

Date of Birth: *

Email Address: *

Phone Number: *

Instagram: *

Who is the Session For? *

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If booking for a loved one, please provide their details:

Loved One’s Full Name:

Loved One’s Date of Birth

Relationship to You

What primary concerns would you like to focus on during the healing session? (Please list physical, emotional, or spiritual concerns.)

Are you currently working with any other healers, therapists, or practitioners? *

If yes, please briefly describe:

What level of healing are you ready to commit to? *

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