Merchant Services
Sessions
1.

1.

To request a private session, please fill in this form. Sessions are provided between 12 noon and 5 pm Pacific time every day.

All fields are required except as indicated.
First Name

First Name


Last Name

Last Name


Address

Address


Phone Number

Phone Number


Email

Email


Best time OR days for session (give 3 choices) 12-5 pm Pacific time

Best time OR days for session (give 3 choices) 12-5 pm Pacific time


Preferred medium of session - phone or in person**

Preferred medium of session - phone or in person**


Preferred method of contact - phone, email, mail

Preferred method of contact - phone, email, mail


Private Sessions - $95 per 30 minutes

We will contact you to confirm your scheduled time and date and supply other pertinent information.

All fields below required.
Bill To

Bill To

First Name*

Last Name*

Address*


City*

State*
Postal Code*

Country*
Email*

Work Phone

Home Phone*

Cell Phone

* Required information.

** In person sessions are held in our facility in most cases. We can travel short distances (30 minutes or less) to in person sessions based on availability of additional time to be alloted for travel. (Travel fee would apply.)
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Joy@UniversalLight.net