Act Attack Therapeutic Theatre Subscription Form

Welcome to our Therapeutic Theatre Subscription Form 🧡 it will take only a few minutes.

Thank you for dedicating your time!

*** 'We gently ask your information for us to create a safe, welcoming & creative space inside the members of our community. Your answers are strictly confidential and will only be used to help us facilitate the best course possible. ***

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Email *
Your name: *
Age: *
Gender: *
Why would you like to join this course? *
What are your expectations? *
Overall how would you rate your physical health? *
Overall how would you rate your mental health? *
Have you ever been diagnosed with a mental disorder before? *
Are you currently taking any medication? *
Do you use any drugs/psychoactive substances? (For exemple: alcohol, caffeine, nicotine, marijuana, and/or certain pain medicines). *
Have you seen a therapist in the recent past? *
Please note:

In Act Attack we are great enthusiasts about mental health and wellness, this is why we'd like to clarify that Therapeutic Theater is not a therapy and should not be perceived as such. To make the most of the course, we highly recommend that Therapeutic Theatre is combined with an individual path of therapy adapted to the needs of each student.

By clicking below you confirm your understanding.
 *
Do you have any questions to understand if this course is suitable for you?
A copy of your responses will be emailed to the address you provided.
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