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When the applicant opens the received document, the sufferer is saved.
The name of the sufferer
[How to specify you]
The country of the sufferer
You are
a sufferer
An applicant
Phone number
Address
[Unclear]
Items which need treatment
（(Mmultiple selection are accepted)
(
Please click the items related to the pain
)
Head
Ear
Eyes
Nose
Mouth
Neck
Sholder
Waist
Knee
Hand
Foot
Joint
Spinal cord
Spirit
Nerve
Bone
Skin
Viscera
Eso
Incurable Disease
Cancer
Soul
Flu
Influenza
Additional respect
※
If the applicant performs unfair actions, the Soul Corps will stop the healing.
※
Please confirm the content before you press the "submit" button.
Non-Disclosure Contract of Personal Information
I,Takashi Hasegara, will strictly observe the rules to not disclose the following personal information obtained through the SLA’s web site.
１.
I will not use personal information obtained from all the pages on the website for my personal gain nor disclose information to the third party.
２.
Personal information means zip code, address, name, date of birth, age, phone number, mailing address and so forth, and I recognize that these items need to be handled with care to prevent a wrongful invasion of privacy.
３.
If I violate the above mentioned, I will not object to receiving the appropriate penalty in concurrence with the proper procedure.
Copyright(C)2009 Nippon Chouaijyutushi-kai all rights reserved