Tucson, AZ
520-591-1245
Ann Marie Chiasson, MD
Restoring Balance through the Heart Center
Integrative & Energy Medicine
Event Registration Form
Please select the event you are registering for:
Personal Information
Event Information
Do you have a limiting health condition?
First Name
Last Name
Gender
Address
City
State
Zip Code
Best Phone #
Email
How did you learn about this event?
Occupation
If so, please describe below.
Payment Information
Cancellation & Refund Policy
By clicking the submit button, I am registering for the above listed event and agree and accept the Payment Policy and Cancellation & Refund Policy as described below.
All cancellations and requests for refunds must be made in writing either through email or regular mail. Please be aware of the following cancellation policies. These strict policies ensure your space at events.
Classes
A full refund less a $25 processing fee will be issued for cancellations made 48 hours prior to the date of the first class. Refunds will not be issued for cancellations made after the above specified period.
Weekend Seminars
A full refund less a $50 processing fee will be issued for cancellations made 5 days prior to the event date. Refunds will not be issued for cancellations made after the above specified period.
Healing Intensives
Initial 50% deposit is non-refundable unless we are able to find someone else to take your place then a full refund less the $300 processing fee will be issued.
Please contact Dr. Chiasson through Email or 520-591-1245 if you would like further information.
Birth Date
Country
All payments are processed through Pay Pal using credit or debit cards. You will be asked for payment on the next screen after clicking the submit button.
Classes & Weekend Seminars
Payment in full is required upon registration.
Healing Intensives
50% deposit is required upon registration. Balance of payment due 7 days prior to intensive.
After clicking the submit button, you will be prompted at the next screen to submit your payment through Pay Pal to secure your registration.
Tucson, AZ
