Solutions for substance use and addictions Telephone: 020 7374 0233

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Please note: The details you enter on this form are not stored on this website they are sent by secure email to the Phil Parker Group where they are stored securely in line with Data Protection Act 1998

Name*

Address

Postcode

Country*

Telephone*

Mobile

Email Address*

Gender*

Date of birth*

How did you hear about The Rediscovery Process?

Thank you for choosing to apply to train with us. If you have any questions, please contact the office on +44 (0) 20 7374 0233.

1. Are you willing to attend and participate in the discussions, training and coaching sessions?*

2. Personal History
How would you describe your addiction issues?*

3. How long have you been using for?

4. Do you believe you can get better/resolve your issues?*

5. Health

It is important for me to know about your general state of health and health history both physically and mentally. To help me assess your suitability for the seminar please tell me if you have any medical or mental health issues that you have not yet mentioned on this form. If so, please list them below:

6. Can you use lifts?

7. I would like to be accompanied at the seminar*

As space can be limited on some courses, please discuss availability with your trainer during your phone call, if you would like to be accompanied. This person will need to complete a separate Learning Facilitator form.

8. Confidentiality*
The Rediscovery Process is a training programme, not a therapy, and there is no requirement for you to share personal information with other members of the group, but some people may choose to do so. Do you agree to maintain confidentiality with regard to personal information shared by others during the training?

9. Payment Details
The training fees for taking the Rediscovery Process training are £695 in a small group setting or £1,997 for a one to one. This includes any pre-course support or coaching, your assessment, 3 half days of training and course materials and 1 hour of follow up phone calls (to use within the year following training). Additional follow up coaching sessions and advanced seminars are available at extra cost after the seminar as needed.

Payment is only payable once you have been accepted onto a course.

10. Training Agreement
You should only sign this application form if you agree to the terms and conditions below and to the following statement:
“I understand that The Rediscovery Process is a training programme. Its purpose is to train me in the tools of the Process, and I realise that simply attending will not guarantee me any results. I recognise the changes I want can best be obtained by fully participating and engaging in the seminars and continuing to apply it after. I am ready and committed to do this.”

If you agree with the above, please type your name here*

The following must be completed if you are under 18 years of age

Please ask your parent or guardian to read through the form and if they also agree to the terms and conditions, for them to sign the form too.

Name:

Relationship to applicant:

Terms and Conditions

Conditions of Payment
Once paid you have seven days to cancel your booking and receive a full refund if training has not commenced. After this fees cannot be refunded in the event of a cancellation on your part, or a failure to complete the training. This is because we run small group trainings with limited spaces; if you take up a space and cancel, no one else will be able to fill it once the course starts. However, if you cancel at short notice and we are able to fill your space your fees will be refunded. We reserve the right to terminate your training if we feel your continued participation would be unhealthy or unhelpful for you or another member of the training group. Your fees will not be refunded in these circumstances.

Cancellation of Seminars
On occasion unforeseen circumstances may make it necessary for us to cancel a seminar and accordingly we reserve the right to cancel seminars where appropriate. In such circumstances you will be given as much notice as possible and we will either refund the full seminar fee or, if you request, move the training to an alternative date. Liability for any losses other than the seminar costs will not be accepted.

Ownership
All documents you receive as part of your training constitute the intellectual property of Phil Parker and are not to be reproduced, sold or distributed in anyway.

Copyright Notice
The purpose of the Process is to apply it to resolve your personal issue(s). Participation in the Process does not amount in any way to permission to reproduce or train others in any of the techniques or materials (including graphical images, text, audio or visual presentation) that are demonstrated or provided.

Data Protection Policy
The Phil Parker Group is registered with The Information Commissioners Office and all information is held in accordance with the Data Protection Act 1998.

You can decide to have your attendance certificate logged, together with your name,
certificate number and e-mail address with Head Office. This
will:

  • Ensure that it can be replaced in case of loss
  • Help us with our research and statistics
  • Help us to check that you have received the high standard of care we expect from members of our register

If you would like this option please check the box below
I would like my attendance certificate logged with name, email address and certificate number:

In addition to the logging of your details for the purposes outlined above, we would also like to occasionally inform you of relevant developments in the Rediscovery Process and its associated programmes. This is an optional service. Your details will never be passed on to anyone else for any reason. Please check the box below if you wish to receive occasional and relevant correspondence from us about this.
I would like to hear about relevant developments in the TRP and associated programmes

In order to conduct further research into the Rediscovery Process we would like to contact you at regular intervals to monitor your progress. We will not use any details by which you may be identified in any statistics that we produce. Please check the box below if you agree to this
I would like to be contacted at regular intervals to monitory my progress

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I would like to keep in touch with Head Office Team through email

Thank you for filling in this form, we will confirm we have received your application by email.

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  • We are here to help…

    If you want to talk through how we could help, or just need more information, please do give us a call 020 7374 0233 or email us