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Home/Counselling – initial form
Counselling – initial formadmin2018-07-20T11:49:58+00:00

Counselling Self Referral Form

  • The Bridge Counselling Service is currently open for new referrals. If you would like to arrange an initial consultation session we require you to complete the following form. All information you supply will be treated in strict confidence, as detailed in our Privacy Policy, but you do need to consent to us holding and processing your data. Please note that completing the form is not a guarantee of counselling but it will allow us to move towards the allocation of an Initial consultation where we can have a discussion with you about whether counselling would be a good way forward for you at this time. Once received we will be in contact with a potential date for the Initial consultation.
  • Date Format: DD slash MM slash YYYY
  • We will assume we can email you about counselling to this address.
  • Initial Consultation
    The more flexibility you have, the quicker you can be seen.
  • Regular Appointments
  • Counselling Options
  • We are committed to keeping your data safe and sound. Find out how your data will be used by reading our privacy policy. If you are happy to continue, please check the box above.
COPYRIGHT © BRIDGE COMMUNITY PROJECT, 2021, ALL RIGHTS RESERVED.
REGISTERED CHARITY: SC045049
AUTHORISED AND REGULATED BY THE FINANCIAL CONDUCT AUTHORITY
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