Refer yourself for free counselling…

To access counselling, please complete the quick form below and then click submit. A member of our team will then contact you, usually within 24 hours.

Post author By ARCUS
Post date 9th Nov 2020

To access counselling, please complete the quick form below and then click submit. A member of our team will then contact you, usually within 24 hours.

First Name(required)

Last Name

How do you identify in terms of your gender/what are your preferred pronouns? (required)

Date of Birth(required)

Email(required)

Phone Number(required)

House Number and Street [first line of address](required)

Town(required)

Post Code(required)

We know some people prefer to see a counsellor of a particular gender and where possible we can try to accommodate this, please indicate your preferences below:(required)

Please indicate here if you are accessing our service via any of the below schemes: PCN or PHD Welfare Scheme

Cornerstone Welfare Scheme

Before you click submit, please confirm the following:(required) I confirm that I have read and agree to all the terms and conditions of service listed on this site.

I am aware that this service is provided free based on my being on benefits and/or a low income and that I am happy to provide evidence of this.

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