Remote Healing Application & Inquiry Form

This page is the application and inquiry form for remote healing on Takatoshi Tokuo’s official website:https://nirvana1000healing.com/english

For those applying for healing:
If you prefer not to send a photo and would like healing directed to an address instead,please enter the address in the “Details of your request” field.

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What would you like to do?required

Start Remote Healing　

Ask a quick question

For those with questions:
If you haven’t checked the FAQ yet, please take a moment to read it first.

Name of the person receiving healing

First Name

Surname　

Name of applicant

Please fill this in only if the applicant’s name is different from the person receiving healing.
First Name

Surname　

Details of your request

Examples: chronic fatigue, unexplained physical discomfort, insomnia, etc.(up to 3 items, within 400 characters).

Program

※The “3 times daily” program and the “60-minute intensive” option can be applied for together.

10days (6,000 Japanese yen)

20days (12,000 Japanese yen)

30days (18,000 Japanese yen)

60days (35,000 Japanese yen)

60-minute intensive（20,000 Japanese yen）

Applicant's country

Applicant's email addressrequired

※When you input a mail address by mistake, I can't send mail to you.

Agreement & Consentrequired

Payment must be made in full with a credit card in your own name. All payments are non-refundable.

If you are applying for healing, please make sure to provide your name and select a program.

For those applying for healing:
After submitting the form, you will receive a confirmation email.
Please reply with your photo attached.
Once your photo and payment are confirmed, we will send you an email with details about the start of your healing.

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