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Directory of Practitioners

Directory Application Form


 

 

 

 

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.:. Application for Directory of Practitioners

You are only eligible for inclusion in the Directory of VAHTC Practitioners if you are able to declare that:

1.  My VAHTC membership fee for the 2008 year has been paid   
2.  I have claimed Practicing Status by completing the Status Declaration Form  
3.  I am covered by professional indemnity insurance   


Your Name:   *  required

Business contact phone:   *     Alternative:
 

Business Location 1 (Suburb or Town):      *     Postcode:   *

Business Location 2 (Suburb or Town):             Postcode:

Qualifications:      *

Modality(s)     *

Special Interest Areas       (Optional)

Business website      (Optional)

Business contact email address:    (Optional)

Note: Email addresses displayed in the Directory will be encrypted to reduce or eliminate their harvesting by spammers.




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