Form – Client

Covid-19 Test Result Submission

om space Covid-19 Test Result Submission Covid-19 Test Result Submission "*" indicates required fields 个人资料 Personal Information 全名 Full Name per IC* First 身份证号码 IC / ID No.* 电话号码 Phone Number Covid-19 Self-Check and Test Result 请问您是否有任何发烧、咳嗽、头痛、身体不适的症状?* Do you have any symptoms of fever, cough, headache, feeling unwell? 是 Yes 否 No 请问您是否在过去14天与Covid-19 Positive的人接触?* Do …

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Session Feedback Form

疗程反馈表格 Session Feedback Form OM SPACE WELLNESS CENTRE "*" indicates required fields 客户个人资料 Client Personal Information 姓名 Name Per IC / ID* Full Name 电话号码 Phone Number*电邮 Email* 心理治疗师 Certified Practitioner*Cmt. Wendy FooCht. Rachel FooCht. Irene Tan疗程类型 Type of Therapy Session*心灵咨询疗程 Consultation Session催眠疗程 Hypnotherapy Session 客户反馈 Client Session Feedback 整体来说,您对疗程的评分 Your overall rating to the …

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Client Intake Form

客户疗程表格 Client Intake Form OM SPACE WELLNESS CENTRE 尊敬的客户,我们将协助您以最快的速度进行专业疗程预约,为此,我们建议您花5分钟的时间填写以下的客户疗程表格以让我们的专业治疗师了解您的情况,并在完成后提交表格。 我们的服务顾问团队将在12小时内与您联系并为您安排预约。感谢您的配合与耐心! Dear Client, we would like to assist you to book appointment as fast as we can, to do so, we recommend that you may take 5 minutes to fill in the Client Intake Form to let our professional therapists understand your situation and submit the form once …

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Seminar Room Rental Registration Form

场地出租注册表格 Seminar Room Rental REGISTRATION FORM OM SPACE SEMINAR ROOM RENTAL REGISTRATION FORM “*” indicates required fields Client Information Details Company Name* Person in Charge Name* First Phone Number*Email* Company Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia …

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Service Request Form

服务申请表格 Service Request Form OM SPACE Service Request Form "*" indicates required fields Type of Service Request*Transfer Between CoursesTransfer Between Sessions or TherapistReserve Payment for Future UseChange of Personal InformationRefund – Course/Session FeeRefund – Bank ChargesRefund – DepositOtherOther Customer Details Full Name per IC / ID* First IC / ID No.* Phone Number*Email* Company Name …

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