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It is with great enthusiasm that we welcome you to Quintinha do Mar!
The information shared is completely confidential and will only be shared with our team, teachers, massage therapists and doctors.

Personal information

Picked Retreat:

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How did you hear about Quintinha do Mar ?

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Emergency Contacts

Medical History

1. Problems or current problems 

Please tick all that apply and / or use the text box below

2. Other medical problems

Se sim, por favor indica-nos detalhes

3. Are you taking any medication (or have you been in the last six months)?

4. Do you have any food allergies / intolerances / preferences?

  Do you think this retreat can help you? If yes, how?

What would you like to reach nos retiros da Quintinha do Mar?


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