THE BLACK THERAPIST DIRECTORY

REGISTER YOUR INTEREST

To join the Black Therapist Directory please register your interest below.

Addition to the directory will require an annual fee of £70

* On being accepted we will require copies of certificates.

We will also require the following:

– A picture for your profile – this can be added during your profile set-up.

– A reference – preferably from your current supervisor.

You will also have a brief interview with a member of the Adira Board.

If you require support or have any queries please contact: adiraboard@adira.org.uk

Full Name

Address Line One

City

Postal Code

Contact Phone Number

Email Address

Please note that if you do not hold a current DBS or Personal Liability Insurance, we will be unable to process your application

Where Are You Based

Years in Practice

Short Bio

Qualifications

Memberships

Therapies Offered

Do you hold a current DBS? *

Yes No

Do you have Personal Liability insurance? *

Yes No

Method of delivering therapy

Face to face Online (Zoom, MS Teams, Skype) Phone

IMPORTANT NOTICE

* On being accepted we will require copies of certificates.

We will also require the following:

– A picture for your profile – this can be added during your profile set-up.

– A reference – preferably from your current supervisor.

You will also have a brief interview with a member of the Adira Board.