Booking Request Form

Pythagoras Insitute of Sound & Vibrational Healing is now based at the Earth Spiritualist Centre at 7 South Mall in Cork City centre. (4th Floor)

For compliance purposes, I am obliged to ask you to answer the following questions prior to attending your class, course, workshop or clinical treatment with Sharon Q. during the pandemic restricted periods.

If your answer is Yes to any of the health questions in Part 4, you are required to stay home and consult a doctor for advice if necessary.

NOTE:  If your booking request is less than 8 hours before the scheduled event start time, please text me by phone as well as submitting this form. Tel: 085 831 3437

2. Event Name

Will You Get the Vaccine?

4. Health Questions (Required - Tick any applicable)

5. Declaration

12 + 4 =

Privacy: Your information submitted will never be provided to a third party without your knowledge and consent, subject to the requirements of the law.