Chinese Healing Arts Center - Rochester Branch
Course Registration Form
| Course | Date(s) | Tuition | | | 6 Day Qi Healer Intensive | | $ 850 | | | 8 Day Qigong Therapist Intensive | | $ 1,500 | | | Seasonal Qigong | | $100 | | | Other: | | $ | Total tuition: | $ |
| Name | | | Address | | | City | | State/Province | | | Country | | Zip/Postal Code | | | Phone | | | E-Mail | | | Date of Birth | | | Profession | | | Previous experience with Qigong: | | Have you ever had, been diagnosed with, or been treated for: psychosis, mania, or bipolar disorder? If so, explain: |
Please make checks and money orders payable to: Donald Londorf, MD Please print out this form and mail it with your payment to: Donald Londorf, MD, L.Ac
Chinese Healing Arts Center - Rochester Branch
1 Grove Street, Suite 117
Pittsford NY 14534
Chinese Healing Arts Center - Rochester Branch
1 Grove Street, Suite 117, Pittsford NY 14534
(585) 234-0302
info@qihealer.org |
