Your Lowback Issue Story

Please, give us details of your situation.

Please tell us when it started? What did cause the problem - injury, work overload, by birth?..
Give details that you're interested to discuss.

 

Your name:

Email:

The details:

 

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"; $send="no"; } if ($_POST[email] == "") { $email_err = "Please enter your email!
"; $send="no"; } if ($_POST[notes] == "") { $notes_err = "Please give more details..
"; $send="no"; } if ($send !="no") { $msg1 .="Name: $_POST[name]\n"; $msg1 .="Email: $_POST[email]\n"; $msg1 .="Notes: $_POST[notes]\n"; $msg2 .="Do not hesitate to contact us by phone 0405673792 or email [email protected] in regards the event.\n"; $to1 ="[email protected]"; $to2 ="$_POST[email]"; $subject1 = "Lowback Issue Story"; $subject2 = "Copy of your Lowback Issue Story"; $mailheaders1 = "From: $_POST[name]"; $mailheaders1 = "Reply: $to2"; $mailheaders2 = "From: Hatha Yoga Space \n"; $mailheaders2 = "Reply: $to1\n\n"; mail ($to1, $subject1, $msg1, $mailheaders1); mail ($to2, $subject2, $msg1, $msg2, $mailheaders2); echo "

Thank you for your interest!

"; } else if ($send == "no") { echo "$name_err"; echo "$email_err"; echo "$notes_err"; echo "$form_block"; } } ?>