Order

Please fill out the remaining fields, copy the page and fax it to: 00 49 2132 9958993 or 00 49 3222 3946830
or email it to: drhansgreuel@web.de

Dr Hans Greuel MD
Moerser Str. 100
D - 40667 Meerbusch
Germany, Europe

First Name
Last Name
Address
City
State
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Country
Phone 

Hereby I would like to register for the 10-days-Biomental-Tele-Therapy. Under the emailadress: drhansgreuel@web.de
(phone-appointment not yet available) I booked the first mail-appointment. In this mail I explain my health situation and wait for the first therapeutic instruction and the link to the first Biomental video- and audiofile for the hometherapy.

At the same time I have transfered the costs of 925,- Euro to the bank account:

Dr Hans Greuel
Deutsche Bank
Kto.-Nr. 0460501
BLZ: 30070024
IBAN:DE93300700240046050100
BIC: DEUTDEDBDUE



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