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Self Management Course Register Form - Perth August 2026

Register Form

Please fill in your details below.
Pain Association Scotland takes your privacy seriously and will only use your personal information:

· To provide you with information on the Association’s services.

· To provide your GP, Pain Clinic or Referrer with information on your attendance at the Association’s groups or courses.

· To improve our service and to contribute to research into chronic pain.

Under GDPR the details are for our records and therefore won’t be shared with anyone else.

A full copy of the policy can be found on our website.

* PLEASE NOTE THAT WE WILL EMAIL YOU ONCE WE HAVE RECEIVED YOUR SIGN UP. SO PLEASE CHECK YOUR JUNK INBOX*
Please note that this sign up is for the Perth 5 in person course starting on Tuesday 25th August 2-4pm. Please fill out your details below
1.Title(Required.)
2.Full Name(Required.)
3.Address(Required.)
4.Phone Number(Required.)
5.Email Address(Required.)
6.Date of Birth(Required.)
7.Who were you referred by(Required.)
8.Please give details of who referred you and their address if you know it.(Required.)
9.Consent: If you are happy to be contacted by the Association then please indicate below how you would like us to contact you. We will only contact you if there is an issue with of the course sessions.(Required.)
Current Progress,
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