Credit Card Authorization Form

Please complete all fields. You may cancel this authorization at any time by contacting us. This authorization will remain in effect until cancelled.

Credit Card Authorization Form


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I authorize Let’s Talk… Coaching & Energy Healing to charge my credit card listed above for the amount agreed in our purchase agreement. I understand that my information will be protected and saved to file for future transaction on my account.
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Disclaimer: Please note that the information on this website and provided during our sessions or seminars are not intended to diagnose, treat, cure or prevent any disease. This information is given strictly for educational purposes. In no way should the information in this website and in our sessions or seminars be considered a substitute for competent medical care by your physician or other healthcare professional.