Heal Disease

I would inferr that the intention is to write out the note and send it down the waters, akin to releasing a wish or prayer. Considering that, I would not flush the prayer down the toilet as that is an act of disposal. ...Consider what goes down a toilet and ask yourself if that sounds like a good place to send a prayer. A natural body of water would be the better choice of the two.

As a tweak to this spell, I would treat it as a prayer to either the elementals who dwell in the water, or the 'spirit' of the river/lake itself. Address the note to the spirits of the river/stream/body of water and ask for their help if bringing healing to the intended person. Take it to the body of water and spend some time at the shore. Bring yourself to the present moment (center) and consciously bring your awareness to your surroundings. Listen to the water and birds. The breeze rustling the trees. Visualize yourself as a part of the natural presence of the area. Then speak aloud your prayer with intent and conviction. Then hold out your hand and let the note fall over the water.

If the paper lands in the water and takes to the current, you can take it as a sign of acceptance of your prayer. Take heart, and walk the shore in the area to pick up any trash , litter, or man-made pollution you can find. Leave the area cleaner than it was when you arrived as a measure of thanks.

If the paper quickly turns to shore and 'beaches', or if it falls and lands on the shore instead of in the water, then it is a sign that something is missing from your prayer, or there is something about the situation that is blocking/rejecting the prayer. Retrieve the prayer paper, and consider additional offerings you might be able to perform. Contemplation and meditation to appreciate the natural space and your purpose in it. Cleaning the area of refuse. Planting wildflowers or other plants -that are indigenous- to the area. Or other things that you might do to support the health of the natural area. Once you have put effort and energy into bettering the area, try the spell again.

If the paper-drop 'fails' and the note has been saturated, torn, or otherwise ruined, then still commit time and effort to bettering the area, but leave for at least a day afterwords. Make a new prayer, perhaps consider the wording and consider how you might clarify or improve it. Consider additional offerings you might be able to bring with you to leave behind. Then try the process again.