Menla Holistic Health Center35 Nod RoadAvon, CT 06001 Tel: 860-409-1501
Menla Registration
Information/Registration: Menla Holistic Health 35 Nod Road, Suite 106 Avon, CT. 06001 860-409-1501 860 231-8263
If sending check, use the form below or mail registration form with check and mail to the address below. For Credit Card Payments, use the form below.
Name:
Email Address:
Profession:
Address:
City:
State:
Zip:
Phone:
To arrange a payment plan or scholarship, please call 860-231-8263
Amount Your Are Paying Today:
Payment Type (Credit Card or Check):
Credit Card Number or Check Number:
CIV Code (on back of card):
Notes