Instant  Healer

making a Pain Free World, one person at a time!
Feel the difference in 10 seconds !

Leave your comments, schedule appointments, event registration/sponsorship, or any suggestions

Currently, we are located here. If you are not able to come to the office for a healing treatment, please fill out the following form so that you will be informed once there are enough people from your city or area to warrant my travel to your country and city.

Please fill out all fields the best you can, then click submit. You will be contacted.

Please fill out as completely as possible:

Last Name *
First Name *
Gender Male      Female
Telephone
Email *
Date of Birth year:      month:
day:
Place of Birth country :  
city:
Residing City/Area: *
Comments or Pain description

Purpose of your comment?(1)Suggestion(2)Appointment(3)Sponsorship(4)Registration for event(5)Others. If requesting an appointment, please clearly state where your pain spots are, how long you had them, what you have done to ease the pain so far, what your doctor's diagnosis were.:
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Fri Mar 29 02:29:03 CST 2024