Please note that this form is no longer in use.
Please use the following form instead:
https://forms.office.com/e/CVBswbEX2d
If you or your client require counselling, please consider the following referral advice:
For NHS funded counselling: self-referral is through the Staffordshire and Stoke on Trent Wellbeing Service on 0300 3030 923, who will carry out a telephone assessment.
For our Low cost counselling and coaching which ranges from £10 - £40 a session (cost is determined on your annual income) with our experienced counsellors call 01283 566696 or use our contact form on our website
https://www.burtonmind.co.uk/contact-usPlease be assured that your information is kept safe and not shared with third parties without your consent. For more information see
https://www.burtonmind.co.uk/privacypolicy