Ōtautahi Trauma-Sensitive Yoga Dates and Times: Group Registration Form

Please read other documents before completing this form

Client Name

First Name

Last Name

Date of Birth

Claim Number

Phone

Client Email

Emergency contact details

Provider Name

First Name

Last Name

Provider Phone

Provider Email

2025 Term 1 - All classes are full

2025 Terms 2, 3 & 4

we will be seeking approval for these classes when applications reopen on the 3rd Feb, but we encourage you to include your request for yoga therapy in your transition wellbeing plan and apply for the PO in anticipation of this approval.

Monday 9.30am - 11.00am Jo & Teresa

Tuesday 10.00am - 11.30am Lucy & Jessie

Tuesday 12.30pm - 2.00pm Lucy & Jessie

Wednesday 5.30pm - 7.00pm Mareile & Jacinda

Thursday 10.30am - 12.00pm Jo & Jacinda

Thursday 1.00pm - 2.30pm Jo & Jacinda

Friday 9.00am - 10.30am this is a mixed gender group with Emma & Jacinda

PO information for 2025 Term 2+ enrolments

(you can copy and past these requirements into your email to ACC) - Vendo/supplier: Visser & Associates #G09948 - Apply for 'Trauma Sensitive Yoga' - Hours/codes needed: SCSGTT x 1 hour and SCSGT x 16 hours - PO date range: 1/4/2025 to 20/9/2025 - Please have the PO copied in to Fiona at admin@visser.net.nz when sent out We also ask you to please complete a Support Plan, this can be found on this website under the yoga tab. The plan must be submitted at least two weeks before the class starts.

Please confirm that you will submit this plan

Please note that registrations for Term 2,3 and 4 2025 will be made under the new SCS contract

We will add this information when all is confirmed with ACC (submissions don't open until Jan 2025). Meanwhile you may specify if you would like to register your client for these terms and we will keep a register and confirm later.

Term 2

Term 3

Term 4

Group is not suitable for people who:

• Are currently experiencing psychosis (and may not be suitable if people have had psychotic symptoms historically) • Are acutely suicidal or who have strong and frequent suicidal ideation • Have been to the Emergency Department or Crisis Resolution for risk issues including suicide or self-harm within the last six months • Have active substance use problems (including regular alcohol and cannabis use) • Are being treated under the Mental Health Act • Are struggling with dissociative symptoms and/or Dissociative Identity Disorder • Have problems with anger and angry outbursts • Have the potential to be a risk to others