Apply for Couples Counselling

To complete this application you will be required to provide information for both you and your partner. Please ensure that you have their consent in both providing this information, and in making an application for couples counselling as it is essential for this service.

Your Details

We will use your preferred means of contact to open a dialogue with you about your counselling. This includes sending you relevant paperwork for you to fill out, most importantly your confidential biographical questionnaire.

Your Partners Details

We will use your preferred means of contact to open a dialogue with you about your counselling. This includes sending you relevant paperwork for you to fill out, most importantly your confidential biographical questionnaire.

Your availability

We need to know when you are free for us to offer an assessment at a time you can attend. Please let us know when you and your partner will both be able to attend the session. The assessment is a one off appointment will not necessarily be the same time and day of your long term counselling appointments.
Please bear in mind that the more availability you provide us with, the quicker we will be able to match you with an assessor with similar availability.