Sign-up form for information sessions
Please fill out this form as completely as possible and click the Submit button when you are done.

Name :
Telephone:
Email :

Are you a patient of the Integral Health Clinic? Yes No

If yes, who is your practitioner?

Please indicate all the topics that your are interested in :

Stress Management Hypnotherapy
Healthy Nutrition Acupuncture
Weight Loss Relaxation
Menopause Immune System Health
Quitting Smoking Bowen Therapy
Arthritis Naturopathy
Diabetes Other, please specify :
 

When would the sessions be more convenient for you?

Days of the week :
Hours :
Preferred language : English French Either


You will be contacted as soon as a workshop on a topic of interest to you is being organized.

For more information, please call us at (613) 241-0005.