Membership Application - Fleurs de Vie Therapist Programme
Last name :
*
First name :
*
Address :
*
Postal Code :
*
City :
*
Country :
*
E-mail :
*
Telephone :
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N° Siret :
*
Web site :
What techniques or therapies do you practice? :
Do you already use flower essence with your clients? :
Yes
No
If yes, which essences do you work with? :
*
Do you prepare dosage bottles for your clients? :
Often
Sometimes
Never
Would you be willing to share your experiences with using flower essences ? :
Yes
No
Captcha : What's 2 + 7 :
*
I wish to receive a copy of my request by email
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