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DHARMA REIKI & ACUPUNCTURE

APPOINTMENT REQUEST

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Appointment Request

If you're booking appointments for multiple people, please submit a separate request for each person.

First name*

Last name*

Email*

Phone*

Is this a mobile number*

Yes

Patient / client status*

New

Existing or returning

Select a service*

Acupuncture

Reiki

Cupping

Reiki distance healing

Reiki for pets, animals

Consultation for Reiki course

Free consultation for all other services

Appointment date - 1st choice*

Time - 1st choice*

Appointment date - 2nd choice*

Time - 2nd choice*

What is the primary issue that you're seeking treatment for*

Additional requests, questions, or comments

PRIVACY & CONSENT FOR ELECTRONIC SUBMISSION:

Please review our Privacy Policy and check below.

By checking this box, I acknowledge that I've been informed about Dharma Reiki & Acupuncture privacy policy, and I consent to the electronic transmission of this form.

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Please be advised that your request is contingent on availability and is pending. We will notify you as soon as possible to confirm your appointment status. Thank you for your patience.

LOCATION & HOURS

9039 Katy Freeway

Building 500, Suite 504

Houston, Texas 77024 Directions

713-922-3474

Tuesday - Friday 9 am - 6 pm
Saturday 9 am - 3 pm
Sunday - Monday closed

APPOINTMENT