Become a service delivery partner

Email*

First Name

Last Name

What is your address (including the town/city and first line of the address)?*

What is your postcode?*

Do you have the legal right to work in the United Kingdom?*

What is your phone number?*

Please list the name and number of your registered company (or specify your status as a Sole Trader)*

Please state your VAT and IR35 details (if relevant as the owner of a registered company)

Which professional registration or accreditation do you currently hold?*

If 'Other', please specify the professional membership you currently hold

What is the full name of your clinical supervisor?*

What is the contact email address for your clinical supervisor?*

Please list the details of your clinical supervision arrangements currently in place*

What is your Information Commissioner's Office (ICO) registration number?*

Please list the name of your first professional/employment reference*

What is the contact email address for your first professional/employment reference?*

Please list the name of your second professional/employment reference*

What is the contact email address for your second professional/employment reference?*

Please list your Disclosure Barring Service (DBS) certificate number*

What is your date of birth?*

Which workforce does your DBS check cover?*

Do we have your consent to make a check against your DBS record on the Update Service?*

Do you have safeguarding training relevant to the delivery of your services which has been issued in the past 2 years?*

Do you have adequate insurance coverage to cover your therapeutic/counselling practice?*

Please provide a brief description of your therapeutic modalities

What type of therapy are you registering to deliver on the Now You're Talking platform?*

If 'Other', please specify.

Do you intend to deliver sessions in-person?*

How long have you been practicing?*

Please tell us if there are any reasonable adjustments we can make to assist you in your application or with our recruitment process

Are you aware of any conflict of interest connected to your partnership with Now You’re Talking?*

Please specify the details regarding any suspected conflict of interest

Do you have any convictions, cautions, reprimands or final warnings that are not ‘protected’ as defined by the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (as amended in 2013)?*

I am aware that additional documentation may be requested as part of the application process, and that Now You're Talking reserve the right to refuse an application where the individual applicant is deemed unsuitable for the regulated role of Service Delivery Partner.*

I’ve read and accept the Privacy Policy for Vendors*

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