TOM MALCHI
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Water Cleanse Group Session Sun 6th Apr ($200)
One-On-One / Private session with Tom ($250)
3 Sessions in a moon ($550)
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It is very important that you share this information accurately and honestly so we can make sure you have the safest and
most beneficial session.
Have you received Kam before?
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Do you currently suffer from any physical/ mental conditions/ severe allergies (please specify)?
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Past surgeries, major illnesses (including psychiatric) & accidents
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Current and past medications and supplements
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Please check the boxes if you have or had any of the following conditions
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Blood Clots
Heart related health issues past or present
Blood pressure issues very high or very low
Any surgeries in the past 6 monthes
Organ transplant
Stroke
Currently Pregnant or Breastfeeding (-1yo)
Normally/or in the past week drink mostly distilled water/ reverse osmosis water without remineralizer
None of the above
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I AGREE THAT I HAVE READ CAREFULLY THIS LIABILITY WAIVER (presented in the link below) AND FULLY UNDERSTAND AND AGREE WITH THEIR CONTENTS.
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