MBSR - 8 Week Programme Registration Form

Thank you for completing this Registration Form and Pre-Programme Questionnaire. We realise the personal nature of some of the questions . Please be assured that the completed forms are kept in strict confidence. 

Pre-Programme Questionnaire

In this course you will learn how to:

  • Be present for yourself and others.
  • Strengthen focus, calm and mental flexibility.
  • Shift self-defeating habits and thoughts.
  • Work with difficult emotions without getting overwhelmed.
  • Build resilience for facing personal and work challenges.
  • Cultivate patience and self-compassion.
  • Develop empathy and more effective communication with others.
  • Re-connect with an appreciation for the simple things in life. 

The MBSR programme aims to enhance physical and mental wellbeing by cultivating mindful awareness of your mind and body.  MBSR may not be appropriate for some people. The programme is designed to help people manage stress and maintain a sustained sense of wellbeing. However, it is not offered for specific physiological or psychological conditions.

We invite you to complete the questionnaire fully to let us know if you have any health concerns or simple care needs that we can support during the course. Though we will do everything possible to support you, we cannot take responsibility for any specific aspect of your health care during the programme. Once we have received your registration we will get in touch to set up a time to talk to you and tell you more about what you can expect from the programme. If you have any questions or concerns about whether this is the right course for you, you will have a chance to discuss this with us then. If we agree that the programme is not right for you at this time we will, of course, return your payment.

Name *
Home Address *
Home Address
Undertaking *
By checking this box you are undertaking to participate fully in this 8 - week Mindfulness Based Stress Reduction Programme and to be fully responsible for your own wellbeing during the programme.