Submission Form For Alternative Therapists
www.alternative-therapists.com

PLEASE RETURN TO THE ALTERNATIVE THERAPIES WEBSITE HERE

This form is to provide information about your method of therapy, contact details and agreement to the criteria for being represented on the Alternative Therapists website which is part of Counselling In France. Unfortunately, because of the strict regulations in France regarding alternative therapists, I will not be able to accept anyone who is unqualified or untrained and who is not registered with URSSAF. You must also have professional insurance covering your work. This form asks you to confirm that.

Please contact me if you have any questions about your submission.

Full name
Address
Town or Village
Post Code
Country
Home Phone
E-mail

Reflexology
Therapeutic Massage
Aromatherapy
Chiropractic
Faith healing
Homeopathy
Indian head massage
Kinesiology
Reiki
Shiatsu
Tai Chi
Yoga
Acupuncture
Other therapies

I am qualified in the therapy I have specified on this form
I am in the process of becoming qualified in the therapy I have specified on this form

I am registered with URSSAF and have insurance
I am in the process of registering with URSSAF and have insurance
I am in the process of registering with URSSAF and do not have insurance yet
I am registered as an association and have professional insurance

I agree to confidentiality within my contract guidelines
I do not work with a contract but I will send details of my confidentiality guidelines
There is no necessity for confidentiality within the therapy I offer
I cannot give any such agreement

Submission Form For Alternative Therapists www.alternative-therapists.com

Submission Form For Alternative Therapists
www.alternative-therapists.com