Planetary Bio-Harmonics

Designed for the
Attunement, Transformation &
the Evolution of Consciousness

Copyright © 2008 Nick Anthony Fiorenza, All Rights Reserved

Introduction

This form is for professionals who have the "Professional Licensing & Support Package" or the "Affiliate Program" (coming soon). If you do not have either package, and wish to provide feedback on the Planetary BIo-Harmonic audio meditations, please use the Personal Feedback Form.

Professional Feedback

Your Name	First		Last
	Email		Affiliate #

Please include the following information, if you have it, for any clients you may reference:

• The date and time of the session.
• Client's Intials.
• Client's Date, Time and Location of birth.
• Additional therpies or technology used.

Your Comments

Note: Client Confidentiality

Personal information of a client such as name, address, or email. provided by a practitioner will not be divulged. This excludes the right to publish the therapist's clinical findings including a client's experience and any relevant astrological data (without divulging a client's name or other personal information) on this web site, in any promotional literature or scientific papers. If there is anything you do not want published, just qualify that in your comments.

Copyright © 2008 Nick Anthony Fiorenza, All Rights Reserved