Anatomy workshop registration form
Please complete the registration form for upcoming anatomy workshops. You can choose to register for one/some/all of the upcoming workshops, just make sure you make the prerequisites before you register. For additional information on the workshops you can visit our website at https://holisticneurohealth.co.za/anatomy-workshops/.
You will receive a confirmation email after submitting the form. If you do not receive any confirmation within a few hours then something might have gone wrong. Please send us an email at info@holisticneurohealth.co.za
Name (as to appear on certificate) *
Your answer
ID number
Your answer
Email *
Your answer
Cellphone number *
Your answer
Anatomy workshop registering for: *
Profession *
Your answer
Address *
Your answer
Vehicle license plate number *
For entry onto premises where course is held
Your answer
I want future information from HNH
Payment details
Account holder: Holistic Neuro Health NPC
FNB Business Cheque account 62772882132
Branch number: 250655

Please note that proof of payment needs to be sent to info@holisticneurohealth.co.za

Cost *
Reference *
Please confirm the reference you put down when you made payment
Your answer
For Health Care Professionals Only
Please fill in the next three questions to enable CPD points to be allocated to you.
Employer
Your answer
Name of Clinic / Practice
Your answer
HPCSA number
Your answer
Comments
Your answer
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