Phone Session Contact Form

Please fill out and submit this form so I can contact you to schedule a healing session. Required fields are marked with a red asterisk. The information you provide is held as private and will not be shared without your expressed permission.

Name*
First Last
Email*
Primary Phone*
Skype name or email

If you live outside of the USA we can speak via Skype.
City/State/Province/Country*
City State / Province / Region Country
Would you like to be added to my email mailing list?*
- Yes
- No
Join my list to receive special offers, workshop information and updates.
I would like to schedule a healing session for:*
- Cat
- Dog
- Horse or other equine
- Myself
- Another species
You may check more than one.
Appointment availability, Eastern Standard Time*
- Weekday mornings: 8-11:00 EST
- Weekday afternoons: 1-4:00 pm EST
- Weekday evenings: 6-7:00 pm EST
Please choose all that apply. Time range reflects session starting times. I do schedule weekend appointments for emergency and acute cases, when needed.
How did you hear about Earth Horse Healing?*

I like to thank those who refer my services to others.
A message for Ginger (optional).

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