Appointment Booking Form

一对一疗程预约

Appointment Booking

OM SPACE WELLNESS CENTRE

"*" indicates required fields

客户个人资料 Client Personal Information

姓名 Full Name per IC / ID*

洋名 Nickname

电话号码 Phone Number*

电邮 Email*

疗程预约 Appointment Booking

想预约的治疗师*

Preferred Certified Practitioner

一对一疗程类型*

Type of Therapy Session

想预约疗程的日期*

Perferred Date for Therapy Session

想预约心灵咨询疗程的时间*

Preferred Time for Consultation Session

想预约催眠疗程的时间*

Preferred Time for Hypnotherapy Session

客户备注 / 留言 Client Note

声明 Disclaimer*

注意：如果疗程已被订满，服务顾问将联系您再次安排最适合您的日期与时间！
Note: If the time slot is unavailable, our Customer Service Team shall arrange the next suitable date and time slot for you.

是，我同意 Yes, I Agree.

Name

This field is for validation purposes and should be left unchanged.

一对一疗程预约