the evolved heart – registration

the evolved heart – registration2017-10-07T19:17:29+00:00
  • Private mentoring and supervision for Mental Health Professionals and Yoga Teachers with NeLi Martin

  • Personal Details

  • (AHPRA / APS / AASW / OTA / Yoga Australia or other) (NeLi is not available to supervise you through the registration process as a psychologist or any other profession. However these sessions can be considered peer supervision for APS CPD requirements)
  • Your Current Therapeutic Frameworks of Practice, or Yoga Orientation; include training and workshops undertaken or given
  • Please describe in detail the kind(s) of yoga and meditation practice you do, for how many years you have practiced and how frequently? (this is NOT a prerequisite)
  • Please give details of any yoga / mindfulness / meditation courses or retreats that you have attended. I am looking for the name of the retreat/course, year you attended, the length of the retreat/course, who taught the course, and where it was held. If you do not recall every detail, that is fine. Please just tell me what you can recall. (This is NOT a prerequisite)
  • Acknowledgement of Risks

    The process of mentoring and supervision in the Mental Health / Yoga field covers your own psychological, spiritual and/or physical responses to your work. You may experience intense or unusual psychological, spiritual and/or physical states. I have considered the risks before choosing to acknowledge this form. I still wish to participate in the program. I accept that in ticking the box below, I will take full responsibility and liability for my own property, health and safety.
    Note: all information here is kept confidential and will be seen only by NeLi Martin and her administrative team.
  • Payment Process

  • To secure your place, please complete and submit this form and make initial payment to
    Commonwealth Bank Australia
    (Janelle Louise) NELI MARTIN
    BSB 064003
    Acc 00607279
    Please use your initial and surname and “TEH” in the reference

    e neli@nelimartin.com
    m 0420221461

    Details of your investment https://nelimartin.com/the-evolved-heart/

  • This field is for validation purposes and should be left unchanged.