Details

New Client Form

Please complete this form before our first session. Only fill out the sections not asterisked if you are happy to do so. I am happy to complete it in our first session, should you prefer.

I hereby agree that this data will be stored and processed for the purpose of establishing contact. I am aware that I can revoke my consent at any time.*

* Indicates required fields
Thank you for submitting your details. We will add them to your personal file.

(1) This contact information is only if you take ill during a session and need assistance returning home or seeking medical attention, or a check-in if it is an online session and you become uncontactable. 

They will not be contacted for any other reason.

(2) We will not contact your GP without permission, unless we have concerns about serious harm to self.

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