Request for Healing Appointment
Healing Appointment Request
If you would like to book a healing appointment please complete the form below
Name *
Email Address *
Contact Number *
Post Code *
So we can ensure the nearest Pranic Healing Therapist contacts you
Condition *
A brief description of what you would like treatment for
Preferred Pranic Healing Therapist
If you know the Therapist you wish to book with, please add their name below otherwise we will aloocate you a Therapist who lives closest to you.
I understand that my contact details will be passed to a Pranic Healing Therapist registered with the Institute of Pranic Healing UK & Ireland and this information will not be given to a third party. I also understand that this information will only be used in conjunction with my treatment and not for any other reason. I understand that that Pranic Healing is not meant to replace conventional medicine but rather to complement it. If symptoms persist a medical professional will be consulted immediately. I hereby release the therapist providing the Pranic Healing treatment and the Institute of Pranic Healing UK & Ireland from any liability as a result of the treatment received.
If you agree with the above, please add your name and date
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