Adult Client application form page 2

Adult Client referral 2021 part 2

Medical information

In order for us to give the best service and keep everyone safe please provide as much information as possible.

Data protection act

Photographic permission

Health and safety disclaimer

Restrictions to acceptance

Please click here to read the restrictions for acceptance of clients. By clicking submit, I confirm that I understand these restrictions for use and that, to the best of my knowledge, all information provided is correct and the client is able to use The Therapy Garden.