confirmation Form

Thank you for booking onto one of our courses!

Please confirm the following details (put ‘none’ if necessary):

Name*

Email*

Main Therapy*

Qualifications?

Professional Body*

Workshop you are attending:

CST1

CST2

SER1

SER2

ADV1

ADV2

CSP1 or 2

Other

IF YOU ARE A QUALIFIED HEALTHCARE PRACTITIONER PLEASE CONFIRM:

I am covered by Professional Liability Insurance

I confirm that the above is true and understand that the information will be relied upon in confirming my place and setting up my record.

IF YOU ARE NOT A QUALIFIED HEALTHCARE PRACTITIONER:

I am not a qualified practitioner and confirm that I understand I will not be able to use this work in a professional capacity.

I am / will be signing up to the Training from Scratch Programme.

I have spoken to the office and given details of my reasons for wanting to come to the course.

I have not spoken to the office. My reasons for wanting to come on the course are given below (we may need to speak to you further)

I am interested in coming to the class because: