Workshop Registration Form

The details that you are registering for are below. Make sure the course details are correct before continuing with your registration.

Course Name: SilverCloud- online therapy
Start Date: 2018-02-02
Time: Whenever suits you
Venue: Online from your device
Location: Online, wherever you are
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Personal Details

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Male Female

GP Details

(These courses are offered free on the NHS and you therefore need to be registered with a local GP to access this service)

We normally keep GP’s informed about people accessing our services. If for any reason you do not wish us to share information with your GP, please tick here.

Course Details

Eastbourne
Halisham
Crowborough
Uckfield
Newhaven
Hastings
Bexhill
St Leonards

Please note: By entering your information into this course registration form, you consent to your data being entered into our (HiM) clinical information systems

Once you have submitted your form, the information you provided will be checked and you will be contacted to confirm the next steps. If for any reason we feel the course is not the most suitable treatment we offer we will contact you to discuss and carry out a more comprehensive assessment of your support needs.