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Request Distance Healing

Distant healing request can be made by writing to us, telephoning us or by using the form below

Title*

Your Name*

Your Email*

Telephone

Address*

Town / City*

County / State*

Postcode / Zip*

Country

Are you requesting... *

Distant Healing for yourself Distant Healing for another person Distant Healing for an animal Distant Healing for yourself and another person or animal

If your request is for another person, please tell us their first name

If requesting healing for another person, do they know of your request?

Yes No

If the request is for an animal, please tell us their name

Please give us brief details of the problem(s)*