Client registration form
Individual counselling
One to one counselling online or in person with a practitioner to explore issues that you might be finding difficult in your life. Individual counselling gives you a space to focus on yourself.
Please complete our form below, this will give us all the information we need to arrange your first appointment. You will be asked to pay an amount for each meeting based upon your household income and using the scale on the form.
Gift Aid
Please consider completing the Gift Aid section at the end of this form. If you’re a UK taxpayer, you can make your counselling contribution worth 25% more, at no extra cost to you. For every £1 you contribute we will receive an extra 25p from HMRC.
We understand this is a long form to complete however we will only ask you for this information once. Please call us on 0131 556 1527 if you would like support to complete the form.
Please read our Counselling agreements and contract for clients before submitting your form.
