Initial Contact Form
Hello and welcome!

You have reached my counselling contact form which is confidential (unless you mention harming yourself or anyone else).  
If you want to ask me questions about counselling and getting started, please give me your contact information here and I will get back to you as soon as I can.  Please be assured that I am a professional and will treat you with respect no matter what you want to talk to me about. 
Confidentiality
Confidentiality is a prime concern for everyone involved and we will keep all of our client’s information confidential. There are occasions when we are unable to keep some of our client’s information confidential, which include (but are not limited to) the following:

a.      Should the counsellor be made aware of the fact that a child or young person, or vulnerable person is at risk of any form of harm, and then we have a duty of care to share this with relevant people/organisations.

b.      If the counsellor is made aware of the fact that the client intends to or is involved in creating an act of terror on society.

c.       If the client makes it known to the Counsellor that they are in the process of committing suicide.

If a breach of confidentiality is thought to be necessary, then the client will be the first person to be consulted.  Following a discussion with the client, the counsellor will then contact the relevant people.

Thank you very much for your interest in my counselling service.  I look forward to receiving your enquiry. 

Kind regards, 

Karen.
Email *
Name *
email address *
Date of birth  *
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What gender do you identify as now (optional)
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Sexuality (optional)
Single or in a relationship (optional)
Give me a short overview of what you want to work on in counselling and what you want to achieve here (also explain any vulnerability you may have here please and advise age if under 18): *
Please give me your weekly availability so that I can book you a consultation.  This will be via Zoom link to your email.  There is no charge for this appointment. Allow up to one hour. *
Please note that I do not offer an emergency or crisis service.  Please confirm that if you need help outside of your sessions, you agree to contact an out of hours service such as Samaritans 116 123 or if you are in crisis that you will go to your local hospital A & E. 

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Please confirm that you respect the boundaries of this service and will take necessary steps to keep yourself safe at all times. 

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A copy of your responses will be emailed to .
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