Send your real first name (surname if you choose) and email. Add your (precise or general) location if you want.
It's not necessary to include what you want healed, but you can in the “Message” field if you like. Permission is key with healing. If you request for another person, please say so and that they gave permission for it.
As soon as I receive your information, you'll be on the healing list! I will email you confirmation along with Mina's description of your health.
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