Registration Form -

Registration Form (Confidential) download

Select the Word or Page version, download, fill out and email me before your first consultation.

Word Format

Please, take the time to fill out the form and email it back to me on consultation day, at the latest. Thank you

PagesFormat for MAC

Please, take the time to fill out the form and email it back to me on consultation, at the latest. Thank you

Montreal Canada and Online

Ingrid Schutt : (514) 991-6316

Ingrid@homeopathe.ca

Bring or send me a copy of your child’s vaccination card if your child was vaccinated.