This referral form is for healthcare professionals only. Please complete the first three boxes with the patient's details.

Patient referral

Confirmation

What programme are you interested in?

Communication preferences

The Centre of Integrated Qigong for Health and Wellness CIC (limited by guarantee) is registered in England and Wales under company number 11628575 at Market House, 4a Church Street, Harletson, Norfolk IP20 9BB.
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