JMI Acupuncture Services

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LOCATIONS & HOURS OF SERVICE:

SANTA ANA, MANILA:

EVERY MONDAYS, & THURSDAYS, 9 AM - 6 PM

SATURDAY & SUNDAY BY SCHEDULE ONLY

SAMPALOC, MANILA:

EVERY TUESDAYS & FRIDAYS, 10 AM - 3 PM

SATURDAYS & SUNDAYS BY SCHEDULE ONLY

INTRAMUROS, MANILA:

EVERY WEDNESDAYS, & SATURDAYS, 10 AM - 3 PM

SUNDAYS BY SCHEDULE ONLY

QUEZON CITY: SOON!

I strongly recommend making an advanced reservation to guarantee my time with you as I do have a busy schedule and to avoid disappointments in assisting you in planning a program that best suits your needs. I will get back soon to you with more updates.

SCHEDULE AN APPOINTMENT

*Initial treatment means the first series of treatments or therapies.

*Follow-Up treatment is a therapy taken by a clinician in helping a client with ongoing problems.

*Kindly answer this form using your laptop or computer.

This Appointment is for
Name
Age, Gender and Nationality
Mobile
Email Address
Appointment Type
Please describe your current concern{s} or health problem(s) for which you are seeking treatment. Kindly include the exact location or part the body (left, center, right, back, side, upper, middle or lower etc), if applicable.
Where would you like to have your treatment? {Note: Service rate might be different base on the location}
Which city are you in right now?
What date work best for you? (MM/DD/YYYY)
Any Specific time?
Payment Method Preferences
Any message or instruction/ complete address for Home or Hotel visit services
Would you agree to reschedule the appointment, if needed?
HOUSE, HOTEL ROOM & OFFICE-VISIT AGREEMENT
- I understand that if I like to have the Acupuncture session in my Hotel Room, Office, or House, the regular service rate will be doubled, and I must shoulder the two-way travel fees of my practitioner. And if it's a walkable distance from her place the rate is the same as in her clinic nearby and there will be no travel fees to pay.
- I understand that if I like to have the Acupuncture session OUTSIDE Metro Manila, I must gather at least five (5) patients minimum to be treated in one day. I must shoulder the two-way travel fees as well as the accommodations of my practitioner(s).
- I understand that I must pay PHP500 as a reservation fee via GCash or PayPal, payable upon booking was made, and it will be deductible from the total amount of the service fee. Refundable within 24 hours, if the appointment was canceled.
- I understand if I will ask for Bodywork/ Massage from my practitioner, I must pay an additional PHP500 for the massage table. The Massage session will never start without a massage table, unless if the location will be at a 4 to 7 stars hotel.
ACUPUNCTURE CONSENT
- I acknowledge that it is my choice to receive the treatment. I am aware of the benefits and the risks and give my consent for treatment. I understand that there is no implied or stated guarantee of success, the effectiveness of individual techniques, or a series of appointments. I acknowledge that treatment is not a substitute for medical care, medical examination, or diagnosis. I have stated all medical conditions that I am aware of and will inform my practitioner of any changes in my health status.
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JMI Acupuncture Services

Better health naturally

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JMI Acupuncture Services

Better health naturally

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