St Dymphna Fund Donations

St. Dymphna Reiki Fund for Cancer Patients
Bringing Hope and Faith to those who Request Healing

Application Request for Assistance:

* Indicates required field

Date of Request: *

Name *

First

Last

Phone Number *

Email *

Address *

Line 1

Line 2

City

State

Zip Code

Country

How Did You Hear About Us? *

Please tell us about yourself and your illness. How it is impacting your life? *

How do you feel receiving Reiki treatments will assist you? *

Please explain to us how your illness has created financial hardship and why you feel you qualify to receive assistance towards receiving Reiki treatments through Soothing Sensations Wellness Center. *

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Application Request for Assistance:

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