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Enter the days or times that you can or can't attend appointments. (You should get an appointment quicker if you can attend at any time).

Enter any information about your needs. For example, if you have a physical disability, if you would prefer counselling in a different language, or if you would prefer a male or female counsellor. We can not always meet your needs, but we will try to do so, and will tell you if we can't.

We always contact people by post. If this is not appropriate in your case, then please tell us how we should contact you.

Telephone
Email
Any of the above

Please enter any additional information that you think might be relevant. There is no need to say why you want counselling.