Healing Assistance

Please submit a request for donations to be allocated to your healing services, along with a brief explanation of the healing you are requesting. In addition, you may also specify the healer you prefer to work with (refer to our list of healing practitioners).

After the funds are allocated, we will give you the contact name of the person who donated the contribution (unless they prefer to remain anonymous.)

This is also a space to ask for energetic support for your intentions and prayers. During a monthly meeting, our healers gather to energize all petitions to manifest the highest good.

Request For Holistic Healing Services

Name

First Name

Last Name

State/Province, Country

Phone

Country

(###)

###

####

Healing Request

Please provide a brief description regarding your healing request and any other information that should be considered for the allocation of available funds.

Special Requests

If you are resonating with or prefer a specific practitioner or a specific healing modality, please list the request below.

What is the Contribution Amount you are requesting?

Energetic Healing Support

Please energize my healing intention and prayers within the healing circle.

My healing intention and prayer:

Disclaimer Acknowledgment

I have read the disclaimer and acknowledge that I'm requesting holistic healing with my own free will.

Healing Request Acknowledgment

Please check one of the following.

I acknowledge and agree that my healing request may be shared publicly, my personal identifying information will remain confidential.

I acknowledge and agree that my healing request may be shared publicly, and give permission to use my first name and last initial.

How did you hear about us?

Other: (or referred by)