Request a Session
Questionnaire:

Questionnaire:

Hi! Yes! you are in the right place. The request-a-session page is attached to the end of my jewelry site. Feel free to peruse the site when you have completed and sent your form. Hit your navigation "back" button to get back to the Interdimensional Healing site. Thanks for visiting.

You do not need to fill it in if you are desiring a "Free Reiki Healing"

Please fill in the questionnaire thoroughly if you are requesting a session with Nirado.

Be sure you have the contact information filled in completely and correctly.

1.  Personal Information

1. Personal Information

First Name*

Last Name*

Company

Address*


City*

State*
Postal Code*

Country*
Email*

Day Phone*

Evening Phone

2.  Session request is for:

2. Session request is for:

Human

or Animal

or Animal


3.  Type of Session: (Please check the one or ones you are desiring)

3. Type of Session: (Please check the one or ones you are desiring)

Reiki

Reiki


Interdimensional Healing

Interdimensional Healing


Holographic Repatterning

Holographic Repatterning


Animal Communication

Animal Communication


Wholistic Healing for Animals

Wholistic Healing for Animals


4.  If you are having a session for a human,

4. If you are having a session for a human,

please answer the following: Do you meditate? How long have you been meditating? What type of meditation are you doing?

5.  and.............

5. and.............

Do you have experience working with your guides? Have you done any past life therapy? Have you had any experience receiving Reiki? Have you experienced Holographic Repatterning before? How long have you been active in your growthwork?

6.  Do you have a specific problem you'd like to work on?

6. Do you have a specific problem you'd like to work on?

Please explain briefly, we will talk about it more thoroughly in session.

7.  If you are having a session for an animal,

7. If you are having a session for an animal,

please answer the following: Animals name: dog or cat? sex: breed: age:

8.  Do you have a specific problem you'd like to work on?

8. Do you have a specific problem you'd like to work on?

Please explain briefly as we will talk about it more in intake:

Cost:

Cost:

Humans - $50 an hour
Animals - $35 for intake, $50 for the session, $35 each session for followup.
10.  What days and times are best for you.

10. What days and times are best for you.