Practitioner Applications

A centre of excellence for Complementary Medicine

THE NATURAL HEALTH CLINIC

Name

Address

Town/City

County

Postcode

Telephone

E-mail Address

Main Therapy Practised

Training College

Current Qualifications

Years in Practice

Membership of Professional Body

Other Therapies Practised

What size of practice do you intend to bring to the Clinic?

Do you work from anywhere else in Bristol?

Why do you want to work at the Natural Health Clinic?

Would you like to opt in to our Outreach Service?

Would you like to participate in our multi-disciplinary Programmes?

How would your therapy fit in to a particular Programme?

Are there any areas of treatment in which you specialise?

Do you have a leaflet on your services?

Please provide a professional reference (e.g. previous employer, etc):

Please provide a character reference:

Other comments

Please note that references will not be approached prior to interview and your permission will be sought before any contact is made.

If called for an interview, please make sure you bring along copies of your insurance, qualifications, membership of professional body and/or any other relevant documents for our records.

This form will be submitted via your default email programme. If for any reason it does not work, please contact us and we will post you a hard copy in the post right away.