Appointment Form
Please fill out the form on the new booking system here https://www.edenwellness.ie
Name
First Name
Last Name
Email
example@example.com
Phone Number
Date of Birth
Occupation
Medical History (medications past and present, diagnoses past and present, etc), any heart or thyroid issues
What is it you would like help with? Can you tell me a bit about how you feel?
What Therapy/ies are you enquiring about?
Hypnotherapy
BWRT (BrainWorking Recursive Therapy)
What treatments / therapies have you tried in the past, if any? How helpful were they?
Where did you hear about my services?
Submit
Should be Empty: