Step 1 of 9
Please complete this quick questionnaire and one of our consultants will contact you for a free 15 minute assessment.
What are your counselling needs?
Building confidence & self-esteem
Changing negative habits
Dealing with grief
Dealing with stress or depression
Figuring out life direction
Help with relationships
Please give a brief summary of the situation
This field is not required, however, adding some brief details here may help speed up the process.
Prefer Not to Answer
How far are you willing to travel?
I want the consultant to come to me (please see FAQs)
up to 5 miles
up to 10 miles
More than 10 miles
I want to interact on the web/phone/skype
Which day(s) are you available for counselling?
Any day is fine
Which time(s) are you available for counselling?
If you require an evening booking please contact us first and we will endeavour to accommodate your request.
Early morning (before 9am)
Evening (weekends 5pm-9pm)
Which type(s) of counselling would you consider?
Face to Face
Online counselling e.g. web chat, Skype
Please create a Username. You are not required to give your real name.
Please provide your personal contact number for ease of communication through WhatsApp/Telegram or for over-the-phone counselling. This is not for any marketing purposes.
This field is for validation purposes and should be left unchanged.
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