Request form Diosa at Home service

Contactformulier Diosa at Home (EN)

Additional Information:

If the desired location is within a maximum of 10km from Diosa (Napelsstraat 118, 2000 Antwerp), a one-time supplement of €20 will be charged to cover transportation costs.

If the desired location is further than 10km from Diosa (Napelsstraat 118, 2000 Antwerp), a one-time supplement of €20 will be charged for the first 10km, with a surcharge of €2/km (one way).

  • If the distance is 20km, a transportation cost of €60 will be charged, in addition to the cost of the treatment.
  • If paid parking is the only option, a one-time supplement of €7.50 will be added to the total amount.

After completing this document, you will receive two things from us:

First:
The quote/invoice for the desired treatment. This will also include an overview of all costs.

After approval:
An anamnesis form for the desired treatment. This must be filled out correctly and truthfully by each person who will receive treatment and must be signed and returned to info@diosa.be before the treatment.

 

If you wish to book the treatment, you must make the full payment. Once we have received the payment confirmation (via email) or payment, your appointment will be booked. You will receive confirmation of this via email.

 

We thank you for your trust and look forward to meeting you so that you can experience a DIOSA experience in your own environment. <3
- Team Diosa

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