Forms

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Any information you provide will remain confidential.

Background Information Form

Please complete part 1 then click ‘continue’ to go to part 2

Background Information Part 1

Placeholder

You must submit part 1 before completing part 2 otherwise the information will be lost

Background Information Part 2

Please click on the following boxes which apply to you:

 

 

Application Form for Fee Reduction

If you would like to apply for a reduction from our standard fee, we invite you to provide some further information, in confidence, about your circumstances and household income. This will enable us to decide on what fee arrangement we are able to offer you.

Your counsellor might suggest the option of coming for sessions fortnightly. This works well for some people. Your counsellor will regularly review the cost of sessions with you.

Application form for a reduction in fees

* Entry required to submit form