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First name
Last name
Email
Phone
Will you be able to take in person therapy sessions?
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Yes
No
If you are taking in person therapy sessions, please provide us the address of the location
Would you require us to arrange a location for in person therapy sessions? (in Ahmedabad)
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Yes
No
Educational Qualifications
Area of expertise
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Per session fee that you shall seek from a client? Please add the amount inclusive of the 20% that shall be forwarded to in a safeheadspace
Would you be wiling to conduct seminars and workshops with in a safe headspace? If yes then on what areas or topics are preferable to you?
Please specify your convenient time for the team to get in touch with you for a brief conversation.
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Submit
Thank you for applying.
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