Application form – Adult

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Application Form - Adult

Notes:

 

  1. Adult programs are delivered only online. Applications for admission and enrollment in the online programs are considered year-round.
  2. Submitted applications do not imply immediate admission. Your application will be considered. In case the selected program is appropriate for you and there are available spots, you will be contacted, in order to proceed with the admission process. The admission process is not completed, unless you receive a formal confirmation of the enrollment.
  3. Submitted applications will be considered for admission on first-cum-first-serve basis.
  4. During the admission process, you might be required to provide relevant documents.

    Name
    Age
    Date of birth
    City and country of residence
    Email address
    Mobile phone number
    Preferred form of communication
    Mother tongue
    Languages you are exposed to, besides your mother tongue
    Educational qualification
    Occupation
    Do you have a formal diagnosis?
    Main complaints
    a. b. d. d. e.
    Previous interventions
    Psychologist
    Behavioural Therapy
    Physical Therapy
    Occupational Therapy
    Sensory Integration Therapy
    Neuromodulation
    Medication
    Other
    Other relevant information about you
    I would like to enroll in
    How did you learn about us?