Please give a brief description of the issues you wish to address in counselling and any other information you feel we need to know. If you have ticked other or multiple factors you can tell us more here:
AVAILABILITY AND FEES
Your counselling will be at the same day and time each week. If your availability changes whilst you are waiting for an appointment, you must contact the centre to inform us.
These measures are in place to help us reduce waiting times and to deliver our services as efficiently as possible.
Kindly tick here to show you have read and understood this statement:
We charge counselling sessions weekly based on your income.
- £5* per session for clients who are in receipt of either ESA, JSA, Income Support or Universal Credit
- £20* per session for clients who earn less than £20,000 per year
- £40 per session for clients who earn £20,000 and above per year
Which fee applies?
*you will be required to bring a proof of benefit or income on your first session
When are you available? Please indicate either yes or no to let us know which half days you will be available to attend your counselling appointment.
**The more options you give us the quicker you will be allocated.**
Morning sessions are 9am, 10am, 11am,12pm
Afternoon sessions are 1pm, 2pm,3pm,4pm
We do not have any availability for evening sessions at the moment. Please check the counselling page on our website for updates.
Answer either YES or NO to each option
**Remember to let us know if your availability changes**
How did you hear about us?:
Optional: you do not need to fill in the following questions if you do not wish to, however we appreciate if you do, as it helps us to ensure that our services reach the widest possible audiences and that they are available to sections of the public that may be underrepresented. This part of the application will be kept separately and anonymously for monitoring purposes only.
Religion or Belief:
Other Religion or Belief:
Other Sexual Orientation: