Cheza Therapy Booking
Booking With Payment
Booking Without Payment
Direct Payment
Booking With Payment
Child's Name
Parent/Guardian's Name
Child's Age
Phone Number
Email
Service
--Select--
AUTISM PLAY THERAPY
AUTISM PARENT TRAINING
Therapist
--Select--
Therapist A
Therapist B
Therapist C (HOME VISIT)
Therapist D (HOME VISIT)
Select Dates & Time Slots
--Slot--
9-11am
11am-1pm
1-3pm
3-5pm
--Slot--
9-11am
11am-1pm
1-3pm
3-5pm
--Slot--
9-11am
11am-1pm
1-3pm
3-5pm
--Slot--
9-11am
11am-1pm
1-3pm
3-5pm
--Slot--
9-11am
11am-1pm
1-3pm
3-5pm
Amount
--Select--
KSh 4,000 One Day
KSh 15,000 Five Days
Mode of Payment
Pay Online
Booking Without Payment
Child's Name
Parent/Guardian's Name
Child's Age
Phone Number
Email
Service
--Select--
AUTISM PLAY THERAPY
AUTISM PARENT TRAINING
Therapist
--Select--
Therapist A
Therapist B
Select Dates & Time Slots
--Slot--
9-11am
11am-1pm
1-3pm
3-5pm
--Slot--
9-11am
11am-1pm
1-3pm
3-5pm
--Slot--
9-11am
11am-1pm
1-3pm
3-5pm
--Slot--
9-11am
11am-1pm
1-3pm
3-5pm
--Slot--
9-11am
11am-1pm
1-3pm
3-5pm