Your event

Fees & availability
£175.00
Standard Rate - pays facilitator and Oxford Mindfulness costs
£150.00
Supported Rate - for those with low incomes
£200.00
Supporting Rate - supports others to attend who are on low incomes

Gift code:    

Personal Information










Where did you hear about the event



I confirm that I am able to speak and understand the English language (both spoken and written) to a level where I can fully take part in the course without the need for additional translation support.

Confirmation of Attendance / Completion of Training Certificate will only be issued if 100% of the training sessions are attended. Please confirm you can meet this requirement.


Yes
No

Health Questions


Additional information

Are there any current life changes (loss of home, job, relationship breakdown, too many work commitments etc.) that may be placing you under additional stress?
Yes
No

Are you currently experiencing depression?
Yes
No

Are you currently receiving any psychiatric or psychological treatments?
Yes
No

Are you currently receiving any talking therapy?
Yes
No

Are you currently taking any medication?
Yes
No

Are your currently using alcohol or drugs in order to manage your stress/distress?
Yes
No

Do you have Diabetes Type 1?
Yes
No

Have you deliberately harmed yourself in the past year?
Yes
No

Have you ever attempted to take your own life?
Yes
No

Have you ever experienced a traumatic event which is currently affecting you?
Yes
No

Have you experienced a manic/hypomanic episode in the past 6 months?
Yes
No

Have you experienced bereavement in the past year?
Yes
No

Have you experienced depression in the past 6 months?
Yes
No

Have you experienced psychotic episode/s in the past?
Yes
No

If you have answered 'Yes' to any of the questions above, please provide additional information below:

The health declaration information you provide is used to assess your suitability for this course. It is kept as confidential and is available to our staff, who may need to contact you for further discussion. Following the submission of your application form, we may contact you to discuss if the course is appropriate for you to attend at this time. If we mutually decide that it is not, you will be refunded in full. Please confirm your understanding of this below.
Yes
No

What do you hope to gain by attending the course?

Equality & Diversity


Male
Female Other
Prefer not to say

Terms & Conditions

Register and pay