Booking Form


Name *

Sex *

MaleFemale

Date of Birth *

Address *

Mobile Phone *

Home Phone

Work Phone

Occupation *

Email *

Current medications

Recent illness

Operations

NoYes

Pregnancy

NoYes

Do you smoke?

NoYes

Alcohol intake

What area in your health would you like to improve? Or anything else I need to be informed of? *

Preferred session

In Person (Sydney Australia)Distance healing (Phone)

*I have read and accept the “Confidentiality”. Yes
*Would you be interested in joining our mailing list?
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<CONTACT NUMBER>
0402 034 145
Nature Care Wellness Centre: 02 8423 8444
Therapeutic Axis (Glebe): 02 9692 9788

<SESSION FEES>

Integrated energetic healing 60 minutes $105
90 minutes $155
Distance Healing one session (between 60 minutes to 75 minutes) $130