Therapist Resources Application Form
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Business Name
Website
What is your profession? (Select all that apply)
*
Hypnotherapist
Counsellor
Psychotherapist
Coach
Reiki Practitioner
Massage Therapist
Other
If you answered 'Other', please provide details.
What relevant qualifications do you hold? (Please list degrees, diplomas, or certifications relevant to your profession.)
*
Are you a member of any professional organisations or accrediting bodies? (e.g., GHR, ACCPH etc.)
*
Yes
No
If you answered 'Yes', please specify.
How long have you been experiencing these challenges?
*
Which resource(s) are you interested in? (Select all that apply)
*
Business Growth and Practice Resources
Workshops and Workbooks
Resellable Products
Hypnotherapy Training Licences (an additional application is needed for this)
Hypnotherapy Level 3 Certificate Licence (an additional application is needed for this)
Counselling Level 3 Certificate Licence (an additional application is needed for this)
CPD Courses
Other
If you said 'Other', please specify.
How do you intend to use these resources in your practice? (e.g., training clients, expanding your business, running workshops, etc.)
*
Do you understand that these resources are for professional use only and that resellable products must be sold under the agreed terms?
*
Yes
No
if you have any questions, please note them here.
Submit
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