Therapy Intent Registration Form 

Foundation Bundle FREE   (normally $50 a month) includes 1 structured counselling session, 1 structured follow-up  session, 120 mins of counselling calls - That's 4 counselling sessions for FREE!

*Structured Counselling and follow-up sessions are not included in the counselling minutes
* Minutes for counselling calls are an on-demand service and you can call us whenever you need a listening ear
* Structured sessions must be booked in advance and are separate from on-demand calls/counselling minutes
* Counselling minutes cannot be carried over to the next month. 
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Email *
Full Name *
Phone number/ Whatsapp number *
Heart Reach Bundle that you are interested in  *
Are you ready to start counselling ? *

Data Collection Disclosure

By submitting this form, you acknowledge and agree to the following:

The information provided will be collected and securely stored for the sole purpose of registering your interest in Heart Reach Counselling Services. Your data will only be used to contact you about our services, updates, and relevant opportunities. We will not share your information with third parties without your explicit consent. You have the right to request access, modification, or deletion of your personal data at any time.

If you have any questions or concerns about how your information will be used, please contact us at admin@heartreachcounselling.com

Thank you for your interest in Heart Reach Counselling Services.

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