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Borana Taraj

Gestalt-thérapeute

* Addresses :

* Language:

* Type of appointment:

Adult

23 years and above

(60 min)

Young adult

20 - 22 years

(60 min)

Young senior

60 - 69 years

(60 min)

Senior

70 years and above

(60 min)

* Place of consultation :

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* Civility

* Name:

* First name:

* Last name:

* First Name:

* Child's civility:

* Date of birth:

* First name partner:

* Name partner:

family composition

* Name:

* First name:

Name:

First name:

Name:

First name:

* E-mail:

* Mobile:

* Country: Please choose a country.

* Postal code:

* City:

* Address:

I accept the Terms and Conditions

I certify that the information provided is accurate and I agree to inform the Logidesk service at least 48 hours before the appointment if I am unable to attend. Otherwise, the consultation fee will still be due.

Bancontact

KBC/CBC

Belfius

You will be redirected to Bancontact after clicking on pay now.

You will be redirected to KBC/CBC after clicking on “Pay now

You will be redirected to Belfius after clicking on pay now.

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