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USR Booking Form - 1 person for £123 (inc.)

Please give us as much information as you can using the form below; as this
will help us develop the most productive treatment approach for you.

Terms and Conditions apply: All parties must be aware of the booking of their U.S.R; acknowledge the date and time of the treatment; and that the U.S.R. preparation practices are understood.

Please allow 24 hours for your order to be processed and acknowledged.
A booking confirmation email will be submitted to the email address provided.

* How may people wish to have a USR?: -

* Recipients Name: -

Recipients Occupation -

* Recipients Town / Location: -

* Recipients Email Address: -

* The Date for Healing: (@ 8pm G.M.T.) -

* Does recipient have any medical conditions?: -

Where did you hear about us?: -

* Do all parties acknowledge the Date and Time?: -

Yes

* Do all parties agree with the Terms and Conditions?:

Yes

* All clients under 16 have given consent?:

Yes

Any further Comments?: -

And... enter the digits below: (hit 'refresh' if necessary)

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