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.
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.