Form CBT-E therapist

    Your name and your location/location of your group or service:

    Contact details that will appear on the CBT-E website:
    (e.g. website address, email address, postal address, telephone number)

    Clients seen:
    Please detail which clients you see in your practice (e.g. diagnoses, age group) and if you work privately and/or within a healthcare system

    Professional Training:
    Please detail your professional role(s), qualification(s) and, if relevant, any registered bodies (with registration number if applicable)

    Training in CBT-E:
    CREDO Online CBT-E TrainingFace-to-face workshopOther

    Face-to-face workshop:
    Please provide name, date and location of training

    Please provide details

    Email address: (required)
    (Only for use by website staff, in case we require further information from you)

    Please provide a photo or image if possible of yourself/your service