Distant Integrity Healing Consultations - Request Form

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Which consultation would you like to request?
Select one
1 Hour Consultation - £100 GBP - Offered for 60 minutes.
2 Week's Consultation - £300 GBP - Offered for 60 minutes daily for 15 days.
1 Month's Consultation - £600 GBP - Offered for 60 minutes daily for 30 days.
What is your core intention for this healing consultation?
Select any one option for 1 hour consultation, any three options for 2 week's consultation and any or all 7 options for 1 month's consultation.
What time of the day do you will to receive the healing consultation?
Select one (Please note that you will receive an email confirming the start day-date of the healing consultations - This is usually after 48 hours of making payment)
9:00 AM
12:00 PM (Recommended)
3:00 PM
6:00 PM
What is your full name?
What is your email address?
Who is this healing consultation request for?
Select one (If requesting for someone else, you can only make a request for a healing client or someone directly in your care as a holistic practitioner)
Myself
Someone else
Any other information relating to the consultation you will to share?
Please review all information provided before submission and check to confirm.
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