Request a counselling appointment

This form is for self-referrals.  If you are wanting to request a counselling appointment for yourself or a loved one – you’ve come to the right place.

 

If you are a Healthcare Professional wanting to make a referral for your client, please submit a Referral Form. Go to the Healthcare Professionals page for more information.

 

This Request-an-appointment form takes an approximately 10 mins to complete, so get comfortable. The good news is that there is an option to save and return later.

 

If you select the ‘Save Your Progress’ button you will be presented a security code on screen that you will need to re-enter when you want to continue with completing the form. 

Is it OK to say who we are when leaving a message?*
Date of Birth*
Do you feel concerned for your safety or the safety of your child/children or someone else? *

IMPORTANT: Wingspan is not a crisis center and our office opening hours vary. If anyone is in immediate danger call 111 and ask for Police. They will arrange protection and support.

If you’re in danger but it’s not safe for you to speak: Stay silent, call 111 then push 55. You will be put through to Police automatically. Listen carefully to the questions and instructions from the call taker so they can assess your call and arrange assistance for you.

For Suicide Crisis Helpline: 0508 828 865 (0508 TAUTOKO).

For Youthline: 0800 376 633, Text 234 or email talk@youthline.co.nz

Any Location - Appointment Times
Central Auckland - Appointment Times
North Shore - Appointment Times
What time of day do you prefer?*

Would you like a Triage Counselling Session?

Wingspan Trust offers Triage Counselling. A Triage appointment is a 'one-off' session with a counsellor. The counsellor will be able to decide whether you need to be assigned to a permanent counsellor urgently or can wait. They will offer strategies to support you and identify other community resources that may help you.

Would you like a Triage Counselling Session?*
Please enter 'None' if you were not referred.

Voluntary Contribution Guidelines*1

We aim to make our counselling accessible to all, so we ask our clients to make a voluntary contribution to Wingspan Trust for each session to help offset some of the costs of the counselling service provided. Please select your voluntary contribution level based on your Total Household Income. Note: family sessions can be up to 1.5 hours in length, and all voluntary contributions are negotiable.

Consent:

Wingspan Counselling is interested in measuring whether changes established during counselling sessions have been sustained. We also value the opportunity to speak with clients about their experience of counselling. Would you be happy for us to contact you 6 months after the completion of counselling?

Agree Consent*
Add Record

Voluntary Contribution Guidelines

We aim to make our counselling accessible to all, so we ask our clients to make a voluntary contribution to Wingspan Trust for each session to help offset some of the costs of the counselling service provided. Please select your voluntary contribution level based on your Total Household Income. Note: all voluntary contributions are negotiable.

Consent

Wingspan Counselling is interested in measuring whether changes established during counselling sessions have been sustained. We also value the opportunity to speak with clients about their experience of counselling. Would you be happy for us to contact you 6 months after the completion of counselling?

Agree Consent*
Add Record
Add Record
Are all parents / caregivers aware of this referral being made for the child/children?*

Voluntary Contribution Guidelines

We aim to make our counselling accessible to all, so we ask our clients to make a voluntary contribution to Wingspan Counselling for each session to help offset some of the costs of the counselling service provided. Please select your voluntary contribution level based on your Total Household Income. Note: family sessions can be up to 1.5 hours in length, and all voluntary contributions are negotiable.

Consent

Wingspan Counselling is interested in measuring whether changes established during counselling sessions have been sustained. We also value the opportunity to speak with clients about their experience of counselling. Would you be happy for us to contact you 6 months after the completion of counselling?

Agree Consent*
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