Schedule Appointment with Mindful Reiki & Meditation

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First Name *

Last Name *

Phone *

Your E-Mail Address *

Notes to Business (your address or any special notes about your order)

Item	Quantity	Total
1 Reiki Session Per Month	x $95.00	$95.00 per month
Total: $95.00	Coupon:

I will show up ready and on time for each scheduled time. If I am unable to make a scheduled time I will let Jess know a minimum of 24 hours in advance via text message. If I miss a scheduled appointment, I forfeit that time/appointment for the month. I am committed to working the program and showing up.