REGISTRATION/ATTENDANCE FORM

Name:

Address:

City:

State:

Postcode:

Email:

Mobile:

Profession:

Professional Association Membership/s:

Dorn Method Workshop(Please circle ) NSW/QLD/VIC/WA/ADE/NZ

Level 1 training (2 days for non healthcare practitioners) $595 (certificate of attainment)

Level 1 (2 day for practitioners only) $660

Advanced Training (2 days for healthcare practitioner who have competed level 1) $660

Master Certification (need to be approved by Dr Jason Mallia) $997

Payment Methods

Can you bring a massage table?

Yes No

Venue: To be confirmed on registration
Please print, scan and send the application to : enquiry@integratedhealth.com.au