Registration for Narrative Model Online Support Session

Please read the following terms and conditions before completing the registration form:

The information provided by you about the case in the form below should be anonymised and brief; further information will be sought in advance of the Support Session if required
The information provided by you will be treated within the usual limits of confidentiality;
It is your responsibility to ensure you have the appropriate consent from your supervisor/agency to have the discussion;
A brief summary of the advice given will be sent by e-mail to you
The advice, guidance and support provided by Psycholological Pathways during the Online Support Session does not constitute an assessment of clinical need or a Clinical Consultation - the aim of the session is to provide technical support on the application of the Narrative Model.

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Registration for Narrative Model Online Support Session

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Name: *

Company: *

Job Title *

E-mail address: *

Telephone/fax: *

Date you attended Narrative Training: *

Agency that provided the Narrative Training: *

Preferred dates for attending the session (see available dates from website): *

How do you wish to attend (at our office, videoconference, teleconference):

I confirm that I have the authority of my employer to incur this expenditure

I have read the terms and conditions for accessing support and agree to same

A brief outline of situation requiring support: *

I herby agree that my data entered in the contact form will be stored electronically, and will be processed and used for the purpose of establishing contact. I am aware that I can revoke my consent at any time.

Note: Fields marked with * are required

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