MIRANDA L. WELTON

Complementary Practitioner & Trainer for 26 years

Caring for the Mind, Body and Soul

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Initial Client Consultation Form

Please fill out the following enquiry form and a consultation form will be emailed to you.

First Name

Last Name

Email

Address

Birthday

Initial Health or wellbeing concerns

Are you currently receiving medical help and if so what?

I have been referred by

I confirm that the information given in this form is true

Thanks for submitting.  I will get back to you soon.

APPOINTMENTS are booked by prior arrangement. Please Email to enquire.

Confidentiality - your session is private and your information is not shared with a third person unless requested by yourself.

Based in Layer de la Haye, Colchester, Essex.

©Miranda Welton 2021 - Holistic Therapies - All Rights Reserved

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