INTAKE FORM

Are you interested in trying craniosacral therapy and visceral manipulation?
As an experienced craniosacral therapist in Amsterdam, I can help you.

Please fill out the intake form below to schedule a consultation.

Your information will be handled confidentially.

Thank you for filling out the intake form!

Water lilies on a lake in Amsterdam
Intake (EN) (#3)

Disease history:

Please answer the questions below in as much detail as possible.

Write down, please, what diseases and complaints did you have or still have?

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