Panchakarma Reservation Form

Deposit Requirement: A 20% deposit is required to confirm your booking. This deposit can be paid by Bank Transfer or Our online payment facility using a Debit or Credit card.

Deposit Refund Policy: Deposits are non-refundable. However, if your plans change, you can apply up to 100% of your deposit to another retreat within 12 months of your original Panchakarma date. Cancellation penalties may apply.

No Credit for Unused Services: No credits will be issued for late arrivals, early departures, or unused services during your Panchakarma stay.

Agreement to Policies: By making a payment, you agree to the Rudra Sahashrara Bali Participants Disclaimer and our Privacy Policy.

Room Type

I want to book Panchakarma for:

What date would you like to start

Note:

The first four days of the menstrual cycle can interfere with detox treatments, please consider this when selecting your dates.
Please book your flight tickets only after receiving a booking confirmation email from us.

Your Personal Information

Title

First name

Last name

Country of Residence

Phone Number

WhatsApp Number

I use the same number for WhatsApp

Have you done Panchakarma before?

Yes

Do you have any serious health issues or recent surgeries?

Yes

IMPORTANT: If you have any existing health issues or have had recent surgeries, please let us know as our Ayurvedic Physicians will need to assess whether you can safely do a Panchakarma (Ayurvedic detox) before your arrival.

Special Request

How did you hear about us?

I have read and agreed to the Retreat Participants Disclaimer and Privacy Policy

Participants Disclaimer