Sound Healing Donation Day Request

Please fill out this form if you want to request a session for the sound healing donation day(s).

For more information about the treatment on offer, see Sound Healing Treatments. The treatment will last an hour and I can include Reiki if you want.

Please note my availability for this is only on the day(s) I have proposed. I cannot make accommodations if this time does not work for you, but I will announce a day every month and it's possible another time it might work out. Allocation is first-come-first serve, however, I will make priority for those on no or low-income.

You do not need to pay anything for the session, but if you would like to make a donation I will gratefully accept. Equally, if you want to exchange another way, that's also an option.

If you have any questions, please message me directly. I'd be happy to answer them :)

Full Name

Email Address

What date are you booking for?

What time would be able to come for a session? (tick all that apply)

Morning (10am to 12pm)

Afternoon (12pm to 5pm)

Evening (5pm to 7pm)

Can you confirm that you are able to travel to Waltham Cross for the session?

Yes

Are you currently on no or low-income?

Yes

How did you find out about this?

Your reason for wanting to receive sound healing:

Please ensure that you read the Contraindications & Data Policy before signing below.

I declare that I have read the contraindications and data policy agreement, and that I am eligible to receive this treatment.

Signed

Thanks for submitting!