Online Healing Request

Please complete this form for requesting Pranic healing for yourself/ others.

Terms and Conditions:

This is a paid healing service. Though our service is on best faith basis, for all online healing requests, advance donation for 1 week is Mandatory. Remaining donation can be paid per weekly basis, for as long as healing is continued.
However, if the healing is completed earlier, remaining amount will be duly refunded
The number and duration of healing varies from patient to patient and depends on various factors. Fees is charged by sitting basis.
You can ask for stopping the healing at any time. Any advance money paid will be duly refunded.
The information you provide here is used for contact and healing purposes only. No private information you disclose will ever be transferred to any third party.
You are required to send regular feedbacks either by calling or through emails or in person, at the periodicity suggested by healer.

*Name of person requiring healing:

*Patient’s Age (years):

*Upload photograph of the person requiring healing:

Please confirm this person has received medical advice prior to your request for Distant Healing?

Yes, I confirm

If yes, please upload the necessary medical documents/reports (total size of the documents must not exceed 5MB)

(please try to optimize the files size. You can also zip all the files to make a single file and upload. Or you can upload individual files):

Brief Medical History of the Patient:

urgent Check this box, ONLY IF healing required is ‘Urgent’:

admitted in ICU Check this box, IF the patient is admitted in a hospital in ICU:
Does the patient know that you have requested Pranic Healing for him/her?

REQUESTER DETAILS

Your name, if request is for someone else:

Your relationship with patient?:

e.g. self, wife, father, brother, cousin, friend, etc.

*Contact E-mail:

*Re-enter E-mail:

*Contact details (Landline / Mobile along with country code, STD code):

Town/county and Country:

Your Time Zone

Please Note:

Please check you have entered your email address correctly. Sometimes replies to healing requests bounce because the sender has made a mistake with the exactness of their email address.
We will contact you via email as soon as possible to confirm receipt. The information you provide will be kept strictly confidential.
This is NOT an automated service. We look at every email and reply to you personally. Therefore, please expect a short delay.
When you request healing help, this will be given with genuine sincerity. However, Pranic Healing is complementary healing and not replacement healing. Therefore, you should continue to take all the medical help and advice offered by your doctor and hospital, in order that you stand the best chance of a recovery.
In case you are receiving our e-mail in your Junk-mail/Spam, mark this e-mail as Not Junk/Spam or add it to your Safe Sender’s list.

Kriyashakti & Feng Shui Courses

Online Healing Request