Your details
What do you need help with?
What's worrying you?
Please describe the main issue you are seeking help for, along with any background details you feel are relevant.
When would you like to see your therapist?
Pre-Work
9am-11am
12pm-2pm
3pm-5pm
Evening
Session details
The details you enter on this document may be seen, in an anonymised form, by the therapist proposed for you. We may contact the therapist to confirm the sessions have started, and are ongoing. Be assured, your privacy is always of paramount importance to us.
Submit details & pay
To submit your details to our experts, please complete the payment
Use the PayPal payment option to complete your order.
Once your payment has been received, it will be matched with your form and one of our team will contact you.
The details you enter on this document may be seen, in an anonymised form, by the therapist proposed for you. We may contact the therapist to confirm the sessions have started, and are ongoing. Be assured, your privacy is always of paramount importance to us.
