Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

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Your Governing Body

Which therapeutic governing body are you registered with? You can choose multiple options.

ACC - Association of Christians in Counselling and Linked Professions

BACP - British Association for Counselling and Psychotherapy

BPC - British Psychoanalytic Council

HGI - Human Givens Institute

NC(P)S - National Counselling (and Psychotherapy) Society

UKCP - UK Council for Psychotherapy

Modalities

Please select your preferred working modalities. You can choose multiple options.

Psychodynamic

Psychoanalytic

Cognitive / Behavioural

Person-centred

Integrative

Systemic

Supportive

Art

CAT

Human Givens

Gestalt

TA

Solution Focused Brief

EMDR

I hereby agree to the terms and conditions outlined in the Membership Agreement (top of page) *

I confirm that I have read, understood, and agree to the terms and conditions.