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ENERGY HYGIENE X

AURA RADIONICS REMOTE SCANNING APPLICATION

Complete this form to apply for remote scanning and healing therapy

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Connect with a good Internet Connection Before Submission
Important Guidelines:
  • Please do not send any pictures without clothes.
  • Please send pictures wearing tight clothing..
  • All fields marked with * are required
  • ALL 13 PHOTOS ARE REQUIRED (except additional photos)
  • Photographs must be taken with a plain background in natural white light
  • No filters, edits, or modifications to photos
  • Ensure good lighting and clarity in all photos

Personal Information

As per official identification
cm
kg

Contact Information

Include country code if applicable

Health Information

0/500
Describe your primary health concerns in detail
0/500
List all symptoms, including frequency and severity
0/1000
Include diagnoses, treatments, medications, and timeline

Required Photographs (ALL 13 ARE REQUIRED)

Important: All 13 photos below are REQUIRED for proper scanning. Upload clear photos with plain background.

Jewellery Images (Optional)

Optional but recommended: Upload clear photos of any jewellery you regularly wear (rings, necklaces, watches, etc.). This helps in accurate scanning as jewellery can affect energy fields.
Drag & Drop Jewellery Photos Here

or click to browse files

Maximum file size: 5MB each | Supports JPG, PNG

Jewellery Photo Guidelines:
  • Upload clear, well-lit photos of each jewellery item
  • Include front, back, and side views if possible
  • Remove jewellery from packaging and photograph against plain background
  • Include photos of any inscriptions, engravings, or gemstones
  • Maximum 10 jewellery photos total
  • File formats: JPG, PNG (max 5MB each)
No jewellery photos uploaded

Additional Photos (Optional)

Drag & Drop Additional Photos Here

or click to browse files

Optional - Supports JPG, PNG up to 5MB each

Consent Form Attachment

Please upload your signed Consent Form in PDF format. The form can be downloaded from our website or received via email.
Drag & Drop Consent Form PDF Here

or click to browse files

Maximum file size: 10MB | PDF format only

Consent Form Requirements:
  • File must be in PDF format
  • Maximum file size: 10MB
  • Document must be signed by the applicant
  • Ensure all pages are included and readable
  • File name should include your name (e.g., John_Doe_Consent_Form.pdf)

Consent & Agreement

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