Suzanne DeWees, Ph.D. Mail order form

If you do not have PayPal, you can send your payment in the form of
a money order or cashier's check with this form. Please print legibly!

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Name	___________________________________________________________________
Address	___________________________________________________________________
City	___________________________________________________________________
Suite/Apt.	___________________________________________________________________
State	___________________________________________________________________
Zip	___________________________________________________________________
Phone	___________________________________________________________________
E-mail	___________________________________________________________________
Send reply via: (Check One)	____ 30 minute reading (Print your phone number legibly above) $70.00 ____ Healing/Reading Combination in Cassadaga(Print your phone number legibly above) $110.00

Print this form, fill it out and mail it accompanied with your question and the
appropriate funds in the form of a Money Order or Cashier's Check to:

Dr. Suzanne DeWees
Post Office Box 218 • 1156 Marion Street • Cassadaga, FL 32706