Form cover
Page 1 of 1

Infinate Vitality Enquiry Form

Your journey back to vitality begins here. Take a moment to share a few details with us so we can connect you with the treatment, retreat, or experience that’s right for you. Once you register, Thora will be in touch at her earliest available. *Please note when on tour this may take a couple of days.

First and Last Name

Phone Number

Email

Your Location

What are you interested in?

What are you interested in?
A
B
C

What are 3 main health challenges you are experiencing and would like support for?

What is the target area/s of focus for treatment?

What is the target area/s of focus for treatment?

Is there anything else you like to share with us?

Where did you hear about Infinate Vitality?

By submitting this enquiry, I understand that Thora will reach out directly to me to discuss.

By submitting this enquiry, I understand that Thora will reach out directly to me to discuss.

Are you interested in having an AO Scan? If so fill in the following information below. This is optional, if you aren't interested in one no need to fill in any further, simply scroll pass and hit "submit." Thora will be in touch soon.


Optional AO Scan Questions

If you wish to receive an AO Scan you must answer all of the below questions including two uploads 1. Your picture and 2. Voice recording.

Date of Birth

Height (in cm)

Weight (in kgs)

Gender

Upload a current and raw picture of your face with plain background, close up, no makeup, no filters. This photo will be kept private for AO Scan purposes ONLY.

Upload a voice recording that says "I AM [your full name] A,B,C,D..." continue to say the alphabet until you reach 20 seconds, for AO Inner Voice Scanning

Thank you for enquiring Thora will be in touch shortly.