Initial consultation form

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Please complete this form in order to use the "How are you" Service to ensure a person-centred interaction.

Our session is every SATURDAY 12.00-17.00 UK time/20.00 - 01.00 Brunei time only. For any queries, please contact our general email, bsu.wellbeing@gmail.com.

Please note that all information you have provided will be only accessible to certain people, which includes the Wellbeing Secretary (Azizan). There will be a disclaimers attached below where we require you to read beforehand, and a consent form we require you to acknowledge.

(This is strictly a Listening Service and NOT a crisis service - For any immediate reaction please contact Samaritans at 116 123 or e-mail them at jo@samaritans.org)

Email *

IMPORTANT: Please Read

Do you agree to the disclaimers? *

Yes

Do you consent us on using your information you've provided?

Yes

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What is your preferred time slot? *Note that the time slots are subjected to a first-come-first-serve basis *

Is this your first time using this service? *

Yes

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