Book a therapy session

Please kindly use the form below to book a therapy session with us and a member of our administration team will respond to you as soon as possible.

We are not a crisis service. Please do not complete this form if you are experiencing a mental health crisis.

For crisis support, please contact the Mental Health Crisis Line on 0300 456 8342, the Samaritans on 116 123 or your GP. For immediate support if you cannot keep yourself safe call 999 or go to A&E.

 

Self Referral Form

Client Information

Who is the Client?
Client Name
Client Name
First
Last
Your partner’s name (for Couples Therapy only)
Your partner's name (for Couples Therapy only)
First
Last
Gender (Client)
Is the Client based in the United Kingdom?

Your Therapy Requirements

Do you wish to see your therapist face to face or online?
Please indicate your preferences for the therapist’s gender
Please indicate the type of therapy you are looking for.
Please indicate how you will be funding. (Our self funding rate for our team of psychologists is £140-£170; CBT therapists, Counsellors and Psychotherapists £100; Couples and Family therapy £120-£150. Insurance Providers accepted by most of our psychologists: AXA Health, Vitality, Cigna, WPA, Aviva and Healix)

Your Availability

The more flexible you can be, the easier it will be to find the right therapist for you.
Locations you can attend

Caring for your safety

Are you / Is the client under the care of an NHS service such as CMHT, CAHMS, FOLS etc.

Other

How did you hear about us?