Peace of Mind First Name *Last Name *Email Address *Birthdate *“Peace of Mind” Refund Policy: Your initial 5 or more sessions package – If you are not fully satisfied after your second clearing session you will receive a full refund upon request. After your second session the fee is non-refundable. Your initial single session – If you are not fully satisfied after your clearing session you will receive a full refund upon request.Please check agree or disagree *AgreeDo Not AgreeDateType your full name below to sign this form. *Submit
