Registration 8 week course | surreyhillsmindful

Registration form
8 week mindfulness for stress course

Send your details together with a deposit of £50 or full payment of £180

Name

Phone Number

Which course are you booking onto?

Spring - starts Jan/Feb

Summer - starts April/May

Autumn - starts Sept/Oct

Have you practised mindfulness before? Please briefly describe any prior experience.

Why do you want to learn mindfulness at this time?

What current stressors are you facing?

Are there experiences you've had in the past that are still causing you stress?

Is there anything relevant from your medical history, including your mental health, which you would like us to know?

Are you currently seeing a mental health professional, and if so, do they know that you are attending this mindfulness course?

Mindfulness practices include gentle stretching and movements. Please describe any physical health restrictions which you would like us to know about.

Are you taking any prescribed medication?

Is there anything else you would like us to know?

Name and phone number of emergency contact

I accept terms & conditionsView terms and conditions

Select an item (£)

Deposit 8 week mindfulness course - £50

Full payment 8 week mindfulness course - £180

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Registration form 8 week mindfulness for stress course

Registration form
8 week mindfulness for stress course