Request for Private Session

Deborah is not currently accepting sessions.
Please feel free to put in your request, however, in case things change.
Thank you.

To assist in the scheduling process, please fill out the following form. Payment is requested at the time of scheduling. All information provided on this form, as well as your session, is 100% confidential.

Please note: This is a clearing session, which is very different than a typical therapy session in that there is very little discussion. The process is extremely time efficient and the information comes in quickly. Discussion tends to slow down the process, so it is recommended that you list what you would like to address in your session on this form. Individual sessions are typically 30-45 minutes, but please allow some extra time in your schedule in case additional time is needed for explanation or to provide clarity.

Remember to hit “Send Form” at the bottom of this page to send your information.

* Required Field

First and Last Name *

City/State *

Your Time Zone *

Email Address *
PLEASE MAKE SURE EMAIL ADDRESS IS CORRECT
This form will not be sent correctly without a valid email address.

Would you like to be added to Deborah's email list? *

Contact Phone Number *
Please Include Area Code
(if international, please enter phone number exactly as it would need to be dialed from the US)

Preferred Method of Communication *
International clients are confirmed by email

How would you like to pay for your session? *
 

What days of the week are you available to START a session between the
hours of 8:00am and 11:00am PST? *
Please check all days that you are available.

Is there anything specific you would like to address in your session?
Please list in numbered format. Details are not necessary. Please be brief, yet specific.

Who referred you or what inspired your interest in a session?

Please leave this field empty.

 I have read the FDA disclaimer (can be found at the bottom of this page)

To submit your payment by check please make payable to:

Deborah Diane
PO Box 3074
Wailuku, HI 96793

~ or ~

To submit your payment with PayPal:

$250

The FDA requires that we inform you…

The US Food & Drug Administration (FDA) prohibits the making of health or therapeutic claims for effects relating to any physical or mental illness except by members of the medical profession and/or other FDA approved licensed practitioners. Conscious Repatterning sessions are powerful catalysts for transformation and self healing, however they are not intended to be a substitute for treatment from an FDA approved licensed practitioner. The content of this web site and the information revealed in your session is meant for educational/entertainment purposes only and has not been approved by the FDA, AMA or any other governmental institution. The services and products herein offered are not intended to replace therapy or medical services. These services are not meant to diagnose, treat or cure any disease, nor do they substitute for a healthy life style, proper nutrition, health regimen or necessary medication. If you are experiencing a mental, emotional, or physical disorder please continue appropriate supervision and/or treatment as deemed necessary by a licensed practitioner. It is your sole discernment as to when, why and how to apply the information made available to you in your session.