Apply to be a Therapist with us!

Complete the Form below to submit your application.

Your Personal Details

Title

First Name *

Date of birth *

Preferred Name

Last Name *

Email *

Mobile *

Your Resume

Upload your Clinical CV *

Upload your Clinical CV

How comfortable are you using computers? *

Your professional details

Profession *

Who are you registered with? *

Provide your registration number *

How many years of therapeutic experience do you have? *

Areas of Interest/Specialisation *

Do you have any conditions imposed on your registration? *

Please provide details

Conditions imposed on registration *

Are you trained or experienced in EMDR ? *

EMDR

How many years of EMDR experience do you have? *

EMDR - Training Level

Your business details

What is your business name, including trading name if applicable? *

Provide your ABN *

Where will you will be practising from?

Address *

City *

State *

Postal code *

Country *