Therapist Registration Form

Stage 1: Information

* Name:

* First Name:

Company:

* Address:

* E-mail:

Phone Number:

Mobile :

Stage 2: Banking Details & Areas of Expertise

* Banking details for payment of services:

Specialist Skills

* Treatments:

* Symptoms treated:

Stage 3: Training

Are you entitled to teach and interested in providing courses?

Yes No

If so, in which field(s)?

Are you interested in à la carte continuing education?

Yes No

If so, in which field(s)?

Stage 4: Observations

Notes:

Dear Therapist, please note that your membership will become effective subject to receipt of your payment of CHF 350 into our postal account as follows:

Association Conservatoire des Thérapies naturelles
Boulevard de Pérolles 34
1700 Fribourg

Banque cantonale de Fribourg – 1701 Fribourg
CCP N° 17-49-3

IBAN : CH89 0076 8300 1281 5020 5

Contact us

Le Passeport Santé
Le conservatoire des thérapies naturelles
Place de la gare 15
1701 Fribourg
tél: +41(0)26 322 88 39
e-mail: contact@au-naturel.ch