Healing Request

If you, or someone you know, wish to receive Distant Healing, please take a few moments to complete the form below. You will receive confirmation within a few days. Note that we do not need very specific information but the more you tell us, the more help that can often be. If you have any concerns about the use to which your personal information is put, please read our privacy policy.

Please note that some of our practitioners need a location to be able to focus their efforts. Many of these people live outside the USA and are not acquainted with the usual practice of abbreviating state names. If you could remember this when completing the form that would be helpful to us in managing your request.

When help is requested, please understand that all those associated with The Distant Healing Network advocate that regular medical help and advice from the subject’s doctor(s) should continue to be sought and followed.

You can use the TABS Key key to navigate this form.

Healing Request

About the Person in need of Healing:

Where They Live:

Requesting healing for the following condition(s):

To reach you:

Please add your E-mail address so that we can confirm receipt of your request.

Thank you.