Please give me reservation in this form by 3 hours before the time of choice.
We will confirm your reservation by return E-mail or by telephone.
Required fields are marked with an asterisk (
*
).
Please select your course :
(
*
)
Studio or In-home
Studio
-
In-home
Studio
Services
Oil massage
-
Shiatsu
Regular massage
Acupunctre
Aromatherapy
Orient A.
Orient B.
Acupuncture
Orient
-
A
.
-
Orient
-
B.
Shiatsu/ Massage
Acupuncture/ Oil massage
Acupuncture to stop smoking
Acupuncture to lost weight
In-home massage Services
Oil massage
-
Aromatherapy
-
Shiatsu
Acupuncture + massage
Option
Not available singly, these options are available only as additions to the other plans.
Foot massage
Face Massage
Date :
(
*
)
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
-
Month
January
February
March
April
May
June
July
August
September
October
November
December
-
Time
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
:
00
10
20
30
40
50
Time :
(
*
)
40min
-
60min
-
90min
-
120min
-
Name :
(
*
)
First Name
Last Name
Sex :
(
*
)
Female
-
Male
-
Address :
(
*
)
Tel :
(
*
)
E-mail address :
(
*
)
Note :
Copyright (C)2006 EGBOK, Inc. All rights reserved.
