Absent Healing Request Form:

First Name*

Last Name*

Email*

Phone

City*

State/Province (if not applicable enter n/a)*

Country*

I am requesting...*

Transitional Healing for a person who has recently passed

Absent Healing for myself

Absent Healing for another person

Absent Healing for an animal

If you selected Transitional Healing please include:

First name only

Date of death

If you selected Absent Healing for another person:

First name only of recipient

Is the recipient aware of your request for healing?

If you selected Absent Healing for an animal:

Name of animal

Species

Age of animal

If you wish, briefly describe the area of concern.

The Inner Quest healers would be happy to hear back from you about the healing experience. Please feel free to share your observations with us, or address any questions you may have in an email to our Healing Facilitator. Thank you for your request. We will be contacting you as soon as possible.

Please verify your request*

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