Perceptual Healing

Perceptual Healing Journey Across America Questionnaire

I want to know what your perception is of your world.
Please fill out and submit this online survey if you would like to be heard.

_____________________________

How often do you laugh?	Never Sometimes Often
Are you: Religious... attend a church regularly and/or Spiritual... practice meditation, kindness, yoga etc	Both Neither
How often are you hugged?	Never Sometimes Often
How often do you initiate hugs?	Never Sometimes Often
Do you meditate?	Never Sometimes Often
Do you exercise?	Never Sometimes Often
Do you consider yourself a healthy person?	Yes No
Do you consider yourself a loving person?	Yes No
Have you healed from a serious illness in your life?	Yes No
Are you interested in being part of the Perceptual Healing Journey Research and documentary ?	Yes No
Would you like us to let you know when we are coming to your area?	Yes No
Are you interested in having us speak to your group or business?	Yes No
Your name
Your email address
Your phone number
Your home address

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You can now purchase the

Perceptual Healing
Chakra Meditation CD

All proceeds from the sale of this CD will be used to support Denise's Perceptual Healing: An American Journey.

To learn more about this journey into America and to order this CD for $20.00 click here.