Kauai retreat contact — Integrative Acupuncture Medicine Inc.

Let’s work together

Thank you for your interest in our unique retreat on the island of Kauai. Please complete the form below.

Name

First Name

Last Name

Email

Phone

(###)

###

####

What is your preferred accommodation?

Private Room

Shared room with King bed

Shared room

Food preference

Vegan

Vegetarian

Gluten Free

Do you have any food allergy?

What is your motivation and goal to attend this retreat

Let’s work together

Thank you for your interest in our unique retreat on the island of Kauai. Please complete the form below.

Name

First Name

Last Name

Email

Phone

(###)

###

####

What is your preferred accommodation?

Private Room

Shared room with King bed

Shared room

Food preference

Vegan

Vegetarian

Gluten Free

Do you have any food allergy?

What is your motivation and goal to attend this retreat