Registration form

Do you want to get started and register right away with Focus Burn-out Treatment? Fill out the form and click on send. As soon as we have received your application, we will contact you within 2 working days. You can also call directly on 085 737 84 29.

We will then schedule a short telephone pre-intake, in which we discuss your request for help and schedule in the final intake.

    Name

    Email

    Phone number

    Reason for signing up