WOMENS
WATERWORKS

Curing Incontinence ...

 
A world-wide best seller
by Dr Pauline Chiarelli
         
 

Workshop Booking Form

Please complete the Form below to book a place in a workshop. Workshops often fill quickly, so confirm you have a place before booking airlines etc.

 

Please Note: This Form may be filled in and printed if you prefer
to fax or post your workshop reservation.

Name(s) (include more than one name here if from the same practice:

Practice Name (if applicable):

Postal address:

Postal Address2

Town:

State:
Postcode

Email contact:

Phone Contact:


Select Workshop &
Preferred Date
(If you wish to attend a workshop please
select the date you
wish to attend)
:
 

Continence & Pelvic Floor Workshop

Male Pelvic Floor Workshop

 
Mail to: Chiarelli HealthCare
14 Magin Cr,
Wallsend 2287
Australia
Fax to: 0249500402
 
 

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