| Online Booking Form 2012 |
Please note: This form is for all retreats except for the Fertility Detox Retreat. Click the following link for the Preconception Fertility Retreat booking form.
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Note: fields marked with * are mandatory |
* Name: |
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Address: |
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* Home Telephone: |
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Work Telephone: |
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Mobile Telephone: |
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* Email Address: |
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* please repeat Email Address: |
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| ** Please note that each person booking needs to submit a separate booking form and health questionnaire. |
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| Type of accommodation required: |
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Single person on the detox course, own room en-suite - £1,395. (£,1425 for Moinhos Velhos, Portugal) |
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2 people sharing a room with twin beds with en-suite bathroom - £1,100. (Option for a shared double bed
at Cortijo Romero and Casa Morisco) Sharing is ONLY available for people who already know each other e.g. friends, partners, family. |
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Single person, own room, shared bathroom with one other guest - £1195. CASA MORISCO only |
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Shared wooden chalet with 2 beds and 2 bathrooms en-suite - £1,195 per person.
MOINHOS VELHOS only |
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Dates required:
(please note availability information, contact us to confirm if 'limited places remaining' is indicated) |
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2012 |
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January 22th - 29th
2012 |
Casa El Morisco, Spain Fully booked |
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March 24th - March 31st
2012 |
Cortijo Romero, Spain Spaces |
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May 5th - 12th
2012 |
Cortijo Romero, Spain Spaces |
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June 23rd - June 30th
2012 |
Cortijo Romero, Spain Spaces |
Transformation Detox Retreat
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July 14th - July 21st
2012 |
Mohinos Velhos, Portugal Spaces |
Transformation Detox Retreat
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Sept 8th - Sept 15th
2012 |
Moinhos Velhos, Portugal Spaces |
Transformation Detox Retreat
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October 6th - October 13th
2012 |
Mohinos Velhos, Portugal Spaces |
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December 2nd - December 9th
2012 |
Casa El Morisco, Spain Spaces |
If you have detoxed before please tell us where and when: |
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Please Note: If the retreat week you would like is shown as fully booked, let us know if you would like to go on the cancellation list as places sometimes become available last minute.
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| Detox Programme Health Questionnaire |
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Age: |
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Date of Birth: |
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Weight (kg): |
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Height (m): |
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| Medical History |
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| Are you receiving treatment from a medical doctor? |
| No |
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Yes |
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If yes, for what condition? |
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| Please provide details of medications (names & doses) and details of any abnormal test results you may have had: |
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| Please give details of any other treatments used such as homeopathic remedies, nutritional supplements etc. |
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| Health Profile |
| Please make a list of all the health problems that you would like to clear up and indicate how long you have had these problems (eg. headaches - 7 years). Please start at number 1 with the problem of the longest duration, ending with the problem that occurred most recently. |
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| How did you hear about Detox International? |
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| Transfers to and from the retreat venue are INCLUDED in the price. Please let us know your flight details AS SOON AS POSSIBLE so we can arrange suitable pick up times. |
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