Registration Form
Coaching, mentoring & therapy

Welcome - you have according to the terms engaged in a personal process and therefore as a minimum need to submit your contact information.
This and the form is for your own convenience and safety plus it saves time and increases the quality of the work.
Process is based on mutual trust, honesty and confidentiality, the practitioner must therefore also know whom he is working with.
Your email etc. will not be shared with third parties – thanks for your understanding and fast cooperation.

Required* information - all emails must be active and for individual use.
Oral bookings and the terms are already legally valid and in force.
This form is a condition for consultation, and failure/delay/neglect of any kind does not cancel your economic obligation.
If you want to cancel your booking without charge, you need to do it by phone and within the deadlines of the terms.


Name and surname:*
Complete address:*
City and code:*
Personal email*
Job and education:*


Partners name and surname:*
Partners complete address:*
Partners city and code:*
Partners personal email:*
Partners mobile:*
Partners nationality:*
Partners age:*
Partners job and education:*

Day/time slot

Other participants

Other participants:


E.g. message (not required):

Check the form (*required) before sending.
And await the receipt, which you can print.

English - by submitting this form, we again declare that we understand and accept below and the terms on the homepage:
Pre-booking is not possible and cancellation/change of an appointment after 09:00 two workdays before the appointment is charged at 100% of the fee, no matter the reason.
In case of delay/failure in the submission of the form, the practitioner reserve the right to reject the client/dispose otherwise of the time at the cost of the client.
All process work (consulting, mentoring, coaching, therapy...) is at the participants own risk and responsibility incl. health, decisions and reactions.
All clients/emails are assigned to the newsletter with e.g. news, information, articles, tools etc. This can later on be cancelled.

Dansk - ved at indsende denne formular, erklærer vi igen at vi forstår og accepterer nedenstående vilkår og vilkårene på hjemmesiden:
Præ-booking er ikke muligt og afbud/ændring af en aftale, senere end kl. 9:00, to arbejdsdage før aftalen, bliver afregnet med 100% af honoraret, uanset årsag.
I tilfælde af forsinkelse/fejl i indsendelse af formularen, forbeholder behandleren sig ret til at afvise kunden/disponere anderledes over tiden for kundens regning.
Al procesarbejde (rådgivning, mentoring, coaching, terapi ...) er for deltagernes egen risiko og ansvar inkl. helbred, beslutninger og reaktioner.
Alle klienter/emails tilmeldes nyhedsbrevet med fx nyheder, information, artikler, værktøjer mv. Dette kan senere afbestilles.

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