This form is to BOOK an appointment. Filling in this form does NOT mean you have paid ! In order to pay please click on the Payment tab, and you will be lead to Paypal. If you have a Dutch bank account, then you can transfer money directly. Details about this are also on the Payment page.
Telephone number:
Email address:
Interested Package :  

In Person Healing 120
Distance Energy Healing 120
Chakra & Hara Assessment 150

Preferred day(s) of the week
Preferred time of day: Morning
No Preference
Any other information/comments:



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