Name *

First Name

Last Name

Phone

(###)

###

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What services are you interested in? *

Energy healing (one-on-one)

Tibetan sound bowl healing (one-on-one)

Private group sound healing (up to 10)

Kids group sound healing (up to 10)

Contraindications Waiver - linked above *

I have read the contraindications for sound healing and confirm that if I have any concerns I will consult my doctor before my session.