What is the name of the company or department or organization you represent. Please provide your name and contact details so that we may contact you with the quote for these services:

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* 1. What is the name of the company or department or organization you represent. Please provide your name and contact details so that we may contact you with the quote for these services:

Please tell us about yourself or your company's needs:

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* 2. Please tell us about yourself or your company's needs:

What kind of corporate wellness service are you looking for?

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* 3. What kind of corporate wellness service are you looking for?

How many people are employed by your company?

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* 4. How many people are employed by your company?

How many people will be included in the corporate service you are enquiring about?

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* 5. How many people will be included in the corporate service you are enquiring about?

Duration of services? If enquiring about an annual contract for employee counselling benefits, please indicate 'Annual' (Be specific and include multiple days if applicable, e.g. 30 minutes, 1 hour, 90 minutes, 3 hours, 4.5 hours, 8 hours,10 hours split 5 hours a day for 2 days, etc...)

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* 6. Duration of services? If enquiring about an annual contract for employee counselling benefits, please indicate 'Annual' (Be specific and include multiple days if applicable, e.g. 30 minutes, 1 hour, 90 minutes, 3 hours, 4.5 hours, 8 hours,10 hours split 5 hours a day for 2 days, etc...)

Where would you like this event to take place?

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* 7. Where would you like this event to take place?

Will food/refreshments be needed for this event? Do you want The Wellness Centre to arrange menu items at an additional cost, otherwise you are welcome to arrange your own?

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* 8. Will food/refreshments be needed for this event? Do you want The Wellness Centre to arrange menu items at an additional cost, otherwise you are welcome to arrange your own?

What are your budget constraints, or expectations for cost of these services:

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* 9. What are your budget constraints, or expectations for cost of these services:

Anticipated date(s) of the services you are seeking (we typically require a minimum of 2 weeks' notice unless it is a crisis):

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* 10. Anticipated date(s) of the services you are seeking (we typically require a minimum of 2 weeks' notice unless it is a crisis):

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