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個別相談申し込み/Indivisual Consultation application
相談申し込み手順/Consultation
Application Procedures
1.
お申し込み/
Application(
フォームへの記載、送信/
Fill in the form, submit)
2.日時確定/
Date and time confirmed(
メールによる返信/R
eply by e-mail)
お問い合わせ: sayako@kidsprouttherapytokyo.org
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* Indicates required question
Email
*
Your email
お名前/Your Name
*
Your answer
お電話番号/Your Phone number
*
Your answer
お子様のお名前と年齢/Your child's name and Age
*
Your answer
ご希望日/Preferred day
*
MM
/
DD
/
YYYY
ご希望時間/Preferred time
*
Time
:
AM
PM
ご相談内容/Details of consultation
*
Your answer
KidSprout Therapy Tokyoのオンライン相談参加に際し、下記内容について承諾いたします/
We accept the following informations when participating in KidSprout Therapy Tokyo's consultation.
*
オンライン相談は、KidSprout Therapy Tokyoでの作業療法セッションを受けるにあたる疑問点などに関して相談をできる機会であることを理解している/I understand that consultation is an opportunity to discuss the questions and other issues of attending the KidSprout Therapy Tokyo Occupational Therapy session.
オンライン相談は30分/10000円、45分/15000円、60分/20000円となります。/The fees for online consultations are as follows:30 minutes /10,000yen, 45 minutes/15000yen, 60 minutes/20000yen.
請求書を受け取り次第、速やかに支払いを済ませます。./I will make the payment promptly upon receiving the invoice.
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