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Appointment

5th Rabi I, 1446 A.H.

Open all week including Weekends & Holidays

Female & Male Practitioners

Click here for Hijri Calendar link

To request an appointment, please fill in the following fields:

Office is Temporarily closed

If you are human, leave this field blank.

First Name: *

Last name: *

Cell Phone: *

Email: *

Age: *

Client Gender: *

Female

Male

Choose the gender of your Hijama Practitioner: *

Female

First time Hijama in general: *

Yes

First time Hijama in our practice: *

Yes

Requested Date: *

Requested Time: *

Do you smoke, vape or use nicotine pouches? *

Yes

Are you experiencing Irregular Menstrual Cycle? *

Yes

Are you currently Pregnant? *

Yes

Reason why interested in Hijama: *

List medications & supplements you take:

Provide your medical history, including prior surgeries and injuries

Requested Hijama Package: *

Hijama (Standard) $85.00 (Recommended for Sunnah & Maintenance)

Hijama Cleanse (Detox) $110.00

(2 in 1) Hijama $145.00 (Adds Knees, Shoulders or Head)

Not Sure

By signing here, I acknowledge that the information provided above is accurate and complete. Upon attending Hijama, I will have read and comprehended the waiver and disclaimer sent to me via email.

Signature: *

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Signature is required.

We welcome cash payments. Unfortunately, we do not accept checks. For added convenience, we accept Credit/Debit Cards, PayPal, and Zelle with an additional charge of $5.00, which will be billed to the client.

For inquiries and questions, Call us at 414-241-4942

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