Registration Form

Form of Address:
Title:
First Name:
Last Name:
Date of Birth:
Nationality:
Field of Study:
Contact Information

Private

Street Address:
ZIP code :
City:
Country:
Phone:
E-mail:
 
 


Business

Institution:
Street Address::
ZIP code:
City:
Country:
Position:
Phone:
E-mail:

Required Qualification Documents

  1. Curriculum Vitae
  2. Certificate of a degree in psychology or medicine
  3. Certificate of a psychotherapeutic qualification or document of proof for acquiring the psychotherapeutic qualification
  4. Evidence of your work in direct patient care within the health care system
Please send the documents as a zip file no larger than 5 MB in total. Individual files can be sent only as docx, jpg, jpeg, gif, png, or pdf.

Click here for instructions on how to create a zip file for Windows or for Mac OS.