Hello beautiful, let's begin your healing
This application will help determine the best plan for Pranic Healing protocols for you, also its a way for me to feel out if we’re the right fit for each other!
Your Full Name *
Email *
Phone number *
Current occupation *
Age *
Current condition and/or symptoms. Please rate each symptom on a scale of 1-10, with 10 being the worst. *
Have you had any serious emotional problems (requiring medicine/therapy) in the past *
Do you currently have any psychological or mental issues, such as fears, phobias, addictions, grief, traumas, etc. *
Check any of the below that applies to you *
Anything else about your situation that you think is important: *
Please list on a separate line all current diagnosis, current prescriptions or treatments for each. *
Are you willing to implement quick energetic practices/ meditation into your day? *
Payment (https://www.paypal.me/harithachiluka) * 4 sessions @$597, *8 sessions @$1197 *12 sessions @$1797 *
Declaration
Pranic healing is NOT a replacement for current medical system. It's a COMPLEMENTARY therapy. (Submitting this form will mean that you agree with the above declaration)
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