EHCAP Registration Form

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Family and Youth Wellness Coaching

Over the last 20 years we have begun to understand how toxic stress effects human development. Research has shown that Adverse Childhood Experiences are linked with altered brain architecture (resulting in difficulties with impulse control and problem solving) as well as higher risk of developing diabetes, ischaemic heart disease and severe obesity.

As founder of EHCAP my vision is to take this knowledge and awareness into communities and into families currently experiencing adversity - sharing straight forward psycho education tools such as Dan Siegel’s Hand Model metaphor for emotion regulation and John Gottman’s Emotion Coaching relationship style.

Benefits of Registering with EHCAP as a Wellness Coach

- we will keep the information you provide on our register of parents and staff cascading Mindful Emotion Coaching or trained to run either Tuning in to Kids or Tuning in to Teens Parent Support Groups

- we will give you the option of using our on line Calendar to promote events you organise

- we will invite you to join a private Whats App chat group with other people on our register

- we will provide on line video coaching at a discounted rate either one to one or in groups

- we will give you discounted rates at our network meetings, Mindful Emotion Coaching updates and a chance to meet others with similar interests

- with your permission we will in due course make the register visible on line using information you provide on this form. We will promote the register with schools, youth services (including police) and health centres looking for family or youth wellness coaches

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Very best wishes

Sarah

Dr Sarah Temple MRCGP
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Full Name* This field is required
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First Name
Last Name
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Post Code or Country if you live outside the UK
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Tell us which best describes your current rolewe will ask your permission to make this visible on line in the next question
Parent or Carer
Work in a Healthcare Setting
Work in a School
Work in Early Help
Other
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Please provide your webpage address if you have one
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Do you give permission for your name, current role, postcode and website address to be visible on our website?
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Mobile Phone Number* This field is requiredThis will be used to link you with our Whats App Group- to opt out use a Land Line number here
Area Code
Phone Number
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E-mail* This field is required
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Training and ExperiencePlease upload certificates if your are Tuning in to Kids or Tuning in to Teens trained
Tuning in to Kids trained
Tuning in to Teens trained
Other (please describe below)
Type option 4
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Please let us know what Emotion Coaching training you have had so far including on line and workshopsIf you have a qualification in Emotion Coaching please upload your certificate
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Certificates in Tuning in to Teens/ Tuning in to Kids or Emotion Coaching qualification
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Safeguarding training in the last 12 monthsThis can be on line or face to face - please provide certificate or detailed description
Children Safeguarding
Adult Safeguarding
Type option 4
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Safeguarding certificate
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Max. file size: 10.6MB
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If you don't have a safeguarding certificate please explain how you keep up to date- eg BASCPAN member
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How do you feel we can best support you in your role?
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