IV DRIP Reservation Form

IV DRIP Reservation Request

Please fill the form below to make reservation.
Full Name*

First NameLast Name
Age*
E-mail*
example@example.com
Phone*

Country CodeArea CodePhone Number
Reservation*
Number of Guest(s)*
Guest 1 IV type select*
Other Requests
For Guest 1
Promotion Code
For Guest 1
Guest 2 IV type select
Other Requests
For Guest 2
Promotion Code
For Guest 2
Guest 3 IV type select
Other Requests
For Guest 3
Promotion Code
For Guest 3
Guest 4 IV type select
Other Requests
For Guest 4
Promotion Code
For Guest 4
Please wait for our confirmation email and reply us back to reconfirm your information details after we receive your email the reservation will be completed. Please note the our email may be sent to your spam/junk mail.*

Acknowledge
If you require for free shuttle service please contact directly via...

Tel: +66 842 498 294

Whatsapp: +66842498294

LINE: @ponsarinclinic

Facebook: ponsarinclinic

Instagram: ponsarinclinic
PONSARIN AESTHETIC & MEDICAL SPA

162/2 Changklan Rd, T.Changklan, A.Mueang, Chiang Mai 50100 THAILAND

Thank you for your reservation.
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IV DRIP Reservation Request