Please fill in the form below, then click "Next". The fields marked * must be completed, other fields may be left blank.
For each therapist / advanced treatment, please upload a scan or photo of their certificate as evidence of an approved qualification ( alternatively you may email these to us quoting Application Number 23283).
The fields marked * must be completed. If you prefer, instead of uploading example files, you may email them to us instead, quoting Application Number 23283 .