MSC 8+1 WEEK PROGRAM: HEALTH DECLARATION FORM

Health Declaration Form

Mindful Self-Compassion 8+1 Week Program

Fill in this form prior to the training tomorrow. Thank you!

Name

NRIC/ Passport Number

Date

Please check the box below

On the night prior to attending tomorrow’s session of the MSC 8+1 week program, I have administered a COVID-19 self-test and the result is NEGATIVE. (Please take a photo/snapshot of your Covid-19 self-test’s result and keep it, but you do not have to upload/show to the organizer)

I am in good health to attend tomorrow’s session of the MSC 8+1 week program.

Address List

7-3, Medan Klang Lama 28, Jalan Klang Lama, 58200 Kuala Lumpur, Malaysia.
+60173311216
inquiry@inpsych.com.my
Only By Appointment
Monday to Saturday: 9am - 6pm Sunday: Closed
Wednesday: Front Desk Off-Day (Kindly contact us via email)

Psychological Services

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Payment

InPsych Psychological Services & Training

A comprehensive psychological services provider that aim to promote and restore mental well-being

InPsych Psychological Services & Training is the brand name of InPsych Sdn Bhd - 201501007705 (1133039-A)