Registration form

We advise you to download the registration form on your computer, from down below, for an immediate registration. Please fill in the form and send it signed to us by mail to:

Praxis für Neuropsychologie und Psychotherapie

Andreas Tiede

Prinzenstr. 5

D-47179 Duisburg   

Related to this issue, we have to indicate that, the data transmission of the registration form by e-mail displays a security gap. Consequential, a complete protection of your data can not be guaranteed.