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South Africa - Benoni

veronica@bewelltoday.co.za

connection sisterhood woman circles coaching support desire goals belonging wellbeing

Be Well Today

Welcome, my practice is devoted to woman's healing, growth and empowerment. Please take a few moments to complete this form so I can understand your needs and how best to support your journey.

First name*

Last name*

Email*

Phone*

Address

Which Service are you Seeking *

Coaching

Reflexology

Both

Previously tried Treatment

Coaching

Reflexology

Both

No, this is my first time

What brings you here today?*

Sexual Issues

Hormonal or menstrual imbalances

Fertility

Anxiety or stress

Intimacy or relationship

Spiritual or personal growth

Wellbeing and health

Other

What time generally works best for you?

Mornings

Afternoons

Evenings

Do you consent to being contacted by me?*

Yes

No

Triskelion safe space

veronica@bewelltoday.co.za

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