for each ACTIVITY, SERVICE and MODALITY, etc. you offer.

Refer to our List of Mainstream Activities on our Activities, Services, Modalities Page.

Our Membership PLUS Package requires you to identify the Services you offer for which you expect to have Cover and support, and needs to be initially Identified and Listed by the Alliance. Your responses are noted in good faith and will be used to support you, should it ever be needed.

This Questionnaire is required for EACH MODALITY / ACTIVITY when purchasing Membership PLUS.

Your responses can be inserted in each line below the question, saved and sent.
Please download, complete and return to asap.
Please use a New Form or Sheet for every Activity even if you provide the service for free.

The Alliance must be confident that your responses can be verified and can be used to support you should you become a person of interest in any legal, claim, complaint or liability situation and thereby your response becomes a legal document.
Once your Activities have been listed a Certificate of Service will be emailed to you as a record. The Certificate of Service entitles you to Constitutional Freedom to Practice for each of the listed activities.

Questionnaire 2021 v02

1Full Name and Membership Number (if known)
2Contact Email and Phone (Mobile)
3Are you a Service Provider or Facilitator ?
4Name and brief description of the Service / Activity / Modality
5Is this a variation of a Mainstream Activity already listed on the Alliance Website?
6Is there a specific website linked to this Service?
7Were you taught or did you develop this Service with experience?
8How long have you been providing this Service?
9Are there: – any pre-requisite qualifications to study for this Service?
10Are there: – any practicing hours to qualify or maintain qualifications?
11Are there: – any training requirements for this Service?
12Have you: – a Certificate of Qualification? From whom and where?
13Do you need to attain Annual Professional Points?
14Is there an accrediting professional parent body for this Service?
15Have you: – any current accreditation for this Service? From who?
16Do you offer this Service to: – Adults?
17Do you offer this Service to: – Children – with or without supervision?
18Do you offer this Service to: – Vulnerable people – disabled, ?
19Do you offer this Service as: – Veterinary Services?
20When providing this Service do you use any: – Consumable Goods? What?
21When providing this Service do you use any: – Devices? What?
22Is there any risk to anyone before, during or after providing this Service?
23Have you: – a Risk Assessment for this Service? Please provide.
24Do you provide this Service: – in a Leased / Rented / Owned Facility?
25Do you provide this Service: – as a Mobile Activity?
26Do you provide this Service: – at Psychic Fairs? Where?
27Do you provide this Service: – in your State? Where?
28Do you provide this Service: – interstate? Where and for how long?
29Do you provide this Service: – overseas? Where and for how long?
30Have you: – a Working With Children Clearance or Exemption? please provide.
31Have you: – a Mental Health Care Qualification? please provide.
32Have you: – a First Aid Certificate? please provide.
33Have you: – ever been refused Insurance for this Service? Details please.
34Have you; – ever been convicted of an offence for your Services? What?, When?