....

 

......Home

......Our Philosophy

......Programs

......Our Difference

......FAQ

......The Facility

......Newsletter

..... Staff

......E-mail

.

.

.

 

.

.

.

.

.

.

.

.

.

.

.

.

.

 

.

..828-669-2331

 


PO Box 17397, Asheville, NC 28816

Participant Application
 E-mail us for updated information

The cost* of the basic 14 day program is
 

 $7,950
 .Married couples.
$14,950

We have other program offerings best suited to a participant's schedule. Prices for these vary, so please call us at 828-669-2331 to discuss your needs.
* cost subject to  change without notice

PLEASE NOTE!
The Oasis Mountain Wellness Center is not operational. The essence of the program is being offered by A Cup of Tea, Asheville, NC

Reservation Info

I hereby  request the following:

___ Roommate

___ Double Occupancy Room (I have roommate)

___ Single Occupancy Room

___ Private Room for Married Couple

___ Forms to Complete for Insurance Reimbursement

___ Certificate of Completion to Furnish to My Attorney

 

Name(s):_____________________________________________________

Address:_____________________________________________________

 Telephone Number:____________________ E-mail___________________

        Social Security Number(s):
        
           Name:________________________________ Number__________________

           Name:________________________________ Number__________________

        Enclosed is my payment of $____________________

        __Check  __ Credit Card

        Credit card name____________________________

        Card number_______________________________ Expiration Date________

I hereby authorize Oasis Mountain Wellness Retreat to conduct a complete background check, including criminal records, credit report, and release of my/our  medical records. I also understand that a complete application including medical intake will be performed upon my arrival

Signature(s):_____________________________________________________

                           :_____________________________________________________