Amythyst
Amythyst
Home
About
Contact and Disclaimer
AmythystMedz
$
Giving
Shop
Pain
Crystal Healing
Account
0
Wishlist
0
Cart
Name *
Age *
Email address *
Is there a specific condition or ailment that you wish to heal or general wellness? *
Medical Issues *
Under the care of a physician regularly
Pacemaker
Diabetes
Metal inside your body
Allergies
Take Prescribed Medication on a Daily Basis
Take Over the Counter Medication on a Daily Basis
Take Herbal or Vitamin Supplements on a Daily Basis
Take Street Drugs on a Daily Basis
Drink Alcohol on a Daily Basis
Other Issues: *
Depression
Anxiety
PTSD
If you would like to elaborate on any of the above answers: *
Are you regularly involved in: *
Mental Health Counseling
Psychological or Psychiatric Care
Religious Counseling
Group Therapy
Have you ever tried: *
Reiki
Sound Healing
Meditation
Guided Meditation
Yoga
Herbal Medicine
Crystal Healing
Music Therapy
Distance Healing
Art/Color Therapy
Would you like to elaborate: *
Leave this field empty
Submit form