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Inquiry for Wellness Services
Inquiries for wellness services for yourself, your family, your pets, or your business
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* Indicates required question
Email
*
Your email
Date
*
MM
/
DD
/
YYYY
Contact Information
First Name
*
Your answer
Last Name
*
Your answer
Phone
*
Your answer
Street Address
*
Your answer
City
*
Your answer
State
*
Your answer
Zip Code
*
Your answer
Services
What services are you interested in for YOURSELF or your FAMILY?
*
Wellness Consultation
Wellness and self-care for myself or my family
Reiki energy healing for myself or my family
Sound healing, frequency healing, and tibetan singing bowls for myself or my family
Therapeutic grade essential oils for myself or my family
Wellness Groups:
https://neurorhythm.com/services/wellness/
None
Other:
Required
What services are you interested in for your PETS?
*
Wellness Consultation
Wellness for my pets
Reiki energy healing for my pets
Sound healing, frequency healing, and tibetan singing bowls for my pets
Therapeutic grade essential oils for my pets
None
Other:
Required
What services are you interested in for your BUSINESS?
*
Wellness Consultation
Wellness Presentation or Vendor Event
Wellness, self-care and burn-out prevention for my business and staff
Reiki energy healing for my business and staff
Sound healing, frequency healing, and tibetan singing bowls for my business, therapy practice, clients, patients, and staff
Therapeutic grade essential oils for my business, therapy practice, clients and staff
None
Other:
Required
In what location are you seeking services?
*
Colorado Springs, CO
Online
Required
Do you have any comments or questions?
Your answer
A copy of your responses will be emailed to the address you provided.
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