BOOK SESSION

REQUIRED INFORMATION

INFORMATION TO BE COMPLETED AFTER PURCHASE

THE SESSION/VOUCHER IS:

For you, personally For another person (family member, friend) For an animal For a non-physical being

ENTER THE NAME OF THE PERSON TO BE TREATED.
IN CASE OF PETS ONLY THE NAME

WRITE 2 LAST NAMES OF THE PERSON TO TREAT

DATE OF BIRTH PERSON OR ANIMAL

E-MAIL

CONTACT TELEPHONE NUMBER

REASON FOR THE CONSULTATION

For treatment to be more effective, attach a general photo(s) of the person/animal:

It is recommended that a specific photo of the person/animal be attached, showing (even pointing with a finger) where it has the disease or damage:

Attach medical or general health reports, if available.

Other observations to add (medication and/or others):

Sessions will be held in order of request, except for emergencies.

IF WANTED YOU CAN ALSO SEND VIDEO OR AUDIO BY WHATSAPP +34 665 05 95 80 or by email info@qiawake.com