Thank you for reaching out. We'd love to learn more so we can help you better and quicker. The information you provide is strictly confidential. Section A is for client information (that is the person engaging in counselling), B, the person responsible for the account payment unless otherwise arranged, C is to be filled out if the client is regarded as a minor or other cases of guardianship. The person filling out the form will receive the responses at the first email address field below. In case you already have an appointment then those fields are not required.