Psychedelic Assisted Integration Psychotherapy (PAIP)

Psychedelic Assisted Integration Psychotherapy (PAIP) Continual Professional Development (CPD)

Registration Form
The next steps ..

Welcome to the intake form for our 130-hour Certificate CPD in Psychedelic Assisted Integration Psychotherapy course. Please be aware that all of the information you provide below will be encrypted and securely stored. We store and protect your personal data in accordance with UK GDPR and ICO guidelines, contact shaura@thepcip.org if you have any questions.
Cohort Start Date*

February 2025

Background & Personal History

The following questions are intended to help us understand more about your background and relevant personal history. Your responses help to inform us of how we might best be able to support your journey through our course.
Have you trained in the helping tradition before?*

YesNo
Please say more about your professional training, let us know the course name, date you received the award and awarding body if there is one ... put N/A if the question does not apply to you.*
Please describe any previous training that may be relevant to your application...*
What is your current job role?*
Do you work with psychedelics? If yes, please explain how...*
Have you been diagnosed with a mental health or neurodevelopmental condition?*
Is there anything else in your background or personal history you would like to share?*
How does it feel to be you at this time?*

Starting Point

Please take some time to reflect on your starting point, you can save your progress and return to the form later if you need time to sit with your thoughts. We want to know where you are in life, and what are you bringing to the cohort.
Why do you feel drawn to this CPD?*
What are you most looking forward to on this course?*
Do you have any concerns about the course or wish to tell us of any specific needs you may have?*

Certify & Submit
Applicant's Name*

First NameMiddle NameLast Name
By signing below, I certify that the information I have provided above is true to the best of my knowledge without any malice, negligence, or any intent to commit acts of misrepresentation. I am also aware that any intentionally false, misleading, or deceptive information provided may result in the automatic refusal of my application or subsequent withdrawal from the course, without recourse to a refund of monies paid towards my course fees.
Signature
Date Signed*

MonthDayYear
Date
Deposit payments can either be paid via PayPal or be transfered to our bank. Our bank details are:

The Pilamaya Centre Ltd

Account Number: 43373199

Sort Code: 608371

Please use reference (PAIP cohort start date, eg PAIP 2025)
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PAIP Deposit£300.00
We will only refund deposits to applicants who we cannot give a place to, otherwise this amount is non-refundable.

Total £0.00

Payment Methods

Debit or Credit Card

Please click one of the PayPal options to complete payment and submit the form.

Psychedelic Assisted Integration Psychotherapy (PAIP) Continual Professional Development (CPD)