Booking Form

Please fill in the details as required underneath and click submit to send to Chiva-Som reservation office. You will be contacted shortly.

All fields marked with asterisk (*) are mandatory.


Arrival Date______________________ Departure Date ________________________

Number of Nights ___________________

Retreat:
Chiva-Som Experience
Fitness
 Spa
Detox
Ultimate Detox
 Physical Remedy
Weight Management
De-stress
Anti-Aging
 

Room Type:
Ocean View
Thai Pavilion
Herbal Suite
Fragrance Suite
Rainforest Suite
Golden Bo

Given Name______________________ Surname______________________

Given Name______________________ Surname______________________

(if two people are sharing please provide both names.)

Your Home Address_______________________________________________

City__________________________ Country______________________

Your Email Address:_______________________________________________

Your Tel/Fax______________________________________

Special Requirements eg twin beds, feather pillows etc____________________

______________________________________________________________

Credit Card Name and Number_____________________________________

Expiry Date__/__

Preferred transfer from Bangkok International Airport  
by car to Chiva-Som   by plane to HuaHin Airport   own arrangements

Preferred way for Chiva-Som to reply to you__________________________

Note:
You can print and fill in details as required and send via fax or mail to the following:

Mail: Chiva-Som, 73/4 Petchkasem Road, Hua Hin, Thailand, 77110
Fax (66) 32 511 154.
Phone: :(66) 32 536 536