Exit this survey Haven Practitioner Application 1. Haven Practitioner Application Form Question Title * 1. What are your contact details? Name: Address: Address 2: City/Town: State: ZIP/Postal Code: Country: Email Address: Phone Number: Question Title * 2. How did you hear about The Haven? Word of mouth Google Other Internet Search Passing by in Ashburton Yellow Pages Around Ashburton Magazine If refered, who refered you? Question Title * 3. What treatments do you offer? Where did you complete your training? Please fill in the number of educational hours completed, and the number of years experience you have in Practice. Have you completed any Further Training / Education? If so please include this.Do you have Professional Liability Insurance? If so with whom? Treatments Training location Educational hours Years in Practice Further Education Insurance Question Title * 4. Would you be happy to offer free taster sessions in order to help build your Practice?If so how many per week? Question Title * 5. How would you describe your treatments?How have clients described them? Question Title * 6. How many hours are you available to do treatments per week? Hours available Question Title * 7. Do you have an existing client base in the area?If so how many clients would you be bringing with you to treat at The Haven? approx number of clients Question Title * 8. How often do clients usually come to see you for treatments? Question Title * 9. What are you planning to do in the way of marketing to build your client base in Ashburton? Question Title * 10. Do you have any particular areas of interest / expertise?If not, what conditions do you have most experience treating? After completing this survey please email me on ashburtonhaveninfo@gmail.com as the survey does not automatically let me know that you've applied.Thank you and I look forward to meeting you. Nicola Done