Online Course permission form

Online Mindfulness Based Living Course - Consent Form

After reading the information below, please complete and submit the consent form to receive the course materials for the upcoming Online Mindfulness Based Living Course.

Peer 2 Peer Mindfulness Living Course Introductory Session
The Peer 2 Peer Mindfulness Based Living Course has 9 course sessions and each is an integral part of the full course. To ensure that you receive the full benefits of the course from the very first week, it is important that you make time for yourself to attend each weekly session.

The next Mindfulness Based Living Course for adults will be held in Early 2021
Please complete the form below if you would like a place on this next course.

Is this Mindfulness Living Course suitable for you at this time?
The course is suitable for most people, and teaches skills and practices designed to help with the difficulties of everyday living. Some participants have particular issues which motivate them to join the course, such as pain, anxiety or illness; others are simply interested in improving their quality of life.

This is the time to consider whether the course is right for you at this time, and if you have any doubts, please contact us and we will give you more information about the course, to help you to make this decision.

Please note that that whilst this mindfulness course can provide major benefits, it is not intended to be a treatment for mental health problems. If you have recently received or are currently receiving treatment from a psychiatrist, psychotherapist or counsellor for an ongoing mental health problem, we strongly advise that you obtain approval from your mental health professional before proceeding further with this course at this time.

Also, if you have recently or are currently going through a traumatic life event such as a separation from a long term partner, the death of a close family member or friend or redundancy this may not be the right time for you to continue with this course. This very much depends on your current psychological health and the support networks that you have around you, such as friends, family and mental health professionals.

If you are currently taking medication for a mental health problem, then we recommend that you do not change your medication, other than in close collaboration with your medication prescriber.

If any of these circumstances apply to you, then if you have not done so already, please contact Peer 2 Peer mindfulness before the course begins to discuss your situation and the support networks you have in place and to explore how you can best be supported during the course.

Please tick this box to indicate that you have read and understood all the above information regarding your suitability to participate on this course.

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Your Email address *

GDPR agreement *

Under the new General Data Protection Regulations (GDPR) we are not permitted to send you emails without your consent. All our course information is sent by email. Please confirm you agree to Peer 2 Peer Mindfulness holding the details above and sending you information related to Peer 2 Peer Mindfulness by ticking the check box in this section.

Your occupation *

Please tell us why learning mindfulness is important to you. *

Please tell us about any mobility or other requirements that you would like us to know about. *

Where did you find out about this course? *

Participating in every session of the online course is important to obtain the full benefits mindfulness offers you.
The course session dates are: to be confirmed

Please let us know in the box opposite if you cannot attend the course on any of the above dates.

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Online Mindfulness Based Living Course - Consent Form

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