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• Resume/CV ✱
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• Full name✱
• Email✱
• Phone ✱
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• Current company

Healthy Minds

• Where did you hear about Peppy?✱
• Are you a Registered Counsellor or Psychotherapist (registered with BACP, UKCP or NCS)?✱

  • Yes
  • No
• How many years of post-qualification experience do you have?✱

  • 0-5
  • 5-7
  • 7-10
  • 10+

Healthy Minds Qualifications

• Please state your BACP register number (if not BACP registered please write N/A)✱
• Please state your NCS register number (if not NCS registered please write N/A)✱
• Please state your UKCP register number (if not UKCP registered please write N/A)

Demographic Survey for Peppy

We invite you to complete this optional survey to help us evaluate our diversity and inclusion efforts. Submission of the information on this form is strictly voluntary and refusal to provide it will not subject you to any adverse treatment or affect your job application. Information obtained will be kept separate from your name or job application. This information will be kept secure and confidential and will be used solely to evaluate our diversity and inclusion efforts.

• What is your age range?
  • 17 or younger
  • 18-20
  • 21-29
  • 30-39
  • 40-49
  • 50-59
  • 60 or older
• I identify my ethnicity as

  Select all that apply

  • Asian
  • Black
  • Mixed / Multiple-Ethnic Groups
  • Other race, ethnicity, or origin
  • White
  • Prefer not to say
• What gender do you identify as?
  • Female
  • Male
  • Transgender Male
  • Transgender Female
  • Non-binary
  • Prefer not to say
• Do you consider yourself to be disabled ?
  • Yes
  • No
  • Prefer not to say
• Which sexual orientation do you identify with?
  • Bi-Sexual
  • Gay / Lesbian
  • Heterosexual / Straight
  • Other
  • Prefer Not to say