Madhavi Rathod

Ayurveda: The World's Oldest System of Natural Healing
Jyotish: Eastern or Vedic Astrology
Reiki: Ancient Eastern Healing Art
Counseling: Has Helped Many Live a Happier, more Prosperous, and Fulfilling Life.
Reiki Treatment Request Form

Please provide the following contact information:

* Required Fields
Current Client? Yes No
Full Name *
Sex Male Female
Street Address *
Address (cont.)
City *
State/Province *
Zip/Postal Code *
Country *
Home Phone *
Work Phone
Cell Phone
E-mail *

Payment will be made:  
*

Send Paypal payments to home@vedichealing.com

Make checks payable to Madhavi Rathod. All checks require two weeks to clear. You will be provided with an address where you may mail your check.

How did you hear about VedicHealing.com?

Please input the dates and times of the week when you would like to receive a treatment. Select times when you will not be asleep, driving, or at work, but when you will be at home in a fairly relaxed state. You will be contacted to arrange a specific time.

Please specify Dates & Times:
Option 1: Example: MM/DD HH:MM
*
Option 2: Example: MM/DD HH:MM
*
Option 3: Example: MM/DD HH:MM

In a Reiki treatment, your entire body will receive energy work. If there are specific areas in your body which you would like given special attention, or is you have specific health ailments, please list those here.

If you must re-schedule your treatment, you must provide at least 48 hours notice in advance of your scheduled time. Without adequate notification, your account will be charged in full for the treatment. We do not provide refunds for any services.

 

 

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