Referral Form

To access counselling or any of our services, please complete the quick form below and then click submit. A member of our team will then contact you. The client is the person who will receive our services, the referrer is the person who is making the referral.

THIS SERVICE IS FOR PEOPLE ON A LIMITED OR ZERO INCOME [unless otherwise agreed]

We will need a method to contact you, please complete the following:

Please note that when we attempt contact, it is important for you to respond. If you do not respond this may result in your referral being closed. Calls may come from a with-held number.

A Kind Request from Arcus

The team at Arcus, pride themselves at providing counselling and support for those who need it, without a nominated charge. Our dedicated team of Volunteers donate their time and experience, and we rely upon donations for our continuing existence. While we do not enforce payment for counselling, we would appreciate any contribution from client’s where possible, without causing further hardship. Any donations made would reflect our belief in confidentiality and would be deeply appreciated for the sustainability of our services. All donations will be discretionary and remain anonymous.