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Candace Durand CH




On a separate piece of unlined typing type paper

 write down in longhand, what you want to accomplish in our work together. Please include questions (no more than 15),

Sign the paper on the bottom, please.

use cursive if you know it or if you can.

 If I sent this to you  Scan all of this and try to make it black and white, not brown, put it under a strong white light send it to me by text, via email, or send it in by post. in care of

Candace Durand, 2302 Rosebud Drive, Billings, MT, 59102 or


Your name


Home Phone

Cell Phone

Email Address







State.ZIP Code


Occupation/Business Type




DOB, age


Gender id--------                     / married or single




Additional Information (Seniors/Military/etc.)


Time zone like MST?




Other/Special Requests


Referred by or how did you find me




Please write on a separate piece of 8x10 paper your issues and wants. Handwritten script if you can. Take a photo of it and send it to me. Please make sure it is in black and white. No brown photos, please. or 406 855 8300  or in care of Candace Durand,2302 Rosebud drive, Billings MT 59102

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