Please submit your request for an intitial consultation only.  Upon receipt of this form, the Miramas receptionist will contact you regarding the next steps.

Existing patients do not need to complete this form.

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Miramas Wellness Centre

50 Sumac Lane

Sherwood Park, Alberta

T8H 0Z5

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"Your inner purpose is to awaken.
It is as simple as that" 
E. Tolle