11730 Manchester Rd.
St. Louis MO 63131
(314) 821-9222
9 to 7 Mon.-Fri.
9 to 5 Sat.
info@
solutionstowellness.com
We do accept Mastercard,
Visa and Discover
Phone: (314) 821-9222
E-Mail:
josephine@solutionstowellness.com
First Name:
Last Name:
Home Phone Number:
Work Phone Number:
Cell Phone Number:
E-mail Address:
Subject:
Please select from the areas that you would like more info on. (Check all that apply)
Nutritional Counseling
Colon Hydrotherapy (Colonics)
Detoxification Program
Ionic Footbath
Homeopathy
Cleansing/Detoxification Programs
Energy Work
MassageTherapy
Breath Work
Lymphatic Drainage
Myofacia Release
Infared Sauna
Meridian Stress Analysis
How did you hear about us?
Website
Phone Book
Friend
Newspaper
Walk-in
Referral/other Dr.
Existing Client
How would you like to be contacted?
Home Phone
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If by Phone, what time of day?
9:00 AM - 1:00 PM
1:00 PM - 5:00 PM
5:00 PM - 7:00 PM
Message:
Wellness Solutions 2009
™
