入力内容保存／読込
保存したデータ読込
現在の入力内容を保存
保存データ削除
保存日：
Reservation/Question form
Jikiden Reiki with Midori
Request resarvation
Jikiden Reiki with Midori is in Walnut Grove, Langley. I will reply to you with details in 24 hours. If you don't get an email, please check your junk mail etc.
Thank you
Name
required
First name
Last name
Mail address
required
confirmation
Menu
required
a Reiki session $60
4 Reiki sessions $220 (valid for 6 month)
Distance Reiki $40 (e-transfer in canada)
Taiken Kai/Trial session Feb 7th
Other
Request your spot for Taiken Kai (trial) Feb 7th
10:00
11:00
12:00
13:00
14:00
15:00
Request Spot for a direct or a distance session
01
02
03
04
05
06
07
08
09
10
11
12
month
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
day
09
10
11
12
13
14
15
16
17
o'clock
00
15
30
45
min
01
02
03
04
05
06
07
08
09
10
11
12
month
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
day
09
10
11
12
13
14
15
16
17
o'clock
00
15
30
45
min
01
02
03
04
05
06
07
08
09
10
11
12
month
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
day
09
10
11
12
13
14
15
16
17
o'clock
00
15
30
45
min
Open hours :
for direct reiki
Monday to Friday 9:30 - 19:00 (last reservagion 17:45)
for distance reiki
Mon to Fri 9:00-23:00(last reservation 22:00)
If you have a request other than the opening hours, please write it in message box
Message/session request
ex, my shoulder pain etc
confirm
このフォームは
Formzu
で作成しました。
