Course Registration

Oncology Massage Module 2 - CONDITIONALLY CONFIRMED

27th November to 29th November 2020
Bell Motel, Preston - onsite accommodation available - facilitated by Anne-Marie Halligan

All - first name? *:
All - middle name(s)? :
All - last name? *:
All - your preferred contact phone number including country or area codes? *:
All - your preferred contact email address? *:
All - your preferred postal address? *:
All - the name and telephone contact details for your emergency contact or next of kin? *:
All - do you have any pre-existing medical conditions (eg, dyslexia, low hearing) or other personal attributes (eg, English as a Second Language) that may limit your learning experience?If yes, what are they? *:
All bar OM1 - why are you registering for this Course? What do you hope to learn? Where do you hope your new skills will take you? *:
All - have you previously attempted to complete this Course? If so, when where and with who? *:
All bar OM1 - do you belong to a professional association(s)? If so, which one(s)? *:
All bar OM1 - do you have current Professional Indemnity Insurance cover? *: yes   no  
All bar OM1 - do you have current Public Liability insurance cover? *: yes   no  
All bar OM1 - do you have a current First Aid Certificate? *: yes   no  
All - against which diseases are you currently vaccinated? *:
All bar OM1 - what recognised professional qualifications do you have in this field? *:
All bar OM1 - what other qualifications do you have? *:
All bar OM1 - are you currently working as a professional tactile therapist? If so, please briefly explain your circumstances? Are you treating clients in frail health, especially those with a diagnosis or history of cancer? *:
All - are you a competent communicator in a language other than English? If so which ones? *:
OM2 - describe how you have been practising the OM1 techniques. *:
After OM2 - where are you working as an Oncology Massage Therapist? How long have you worked there? *:
After OM2 - when and where did you complete OM2 and who was your Course Facilitator? *:
All - are you able to bring your own massage table? If not, are you prepared to incur a small fee if tables need to be hired? *:

Qualifications * :

Non Massage Qualifications:

How did you hear about this program?:


Your Payment: Pay Full Amount or Depost (min $50)

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