English Psychological Consultation Service Application ( Korean Psychological Association )
Dear many of you who are suffering aftermath the 10.29 Itaewon incident. We wish to stand with you and give support based on our psychological profession. 
Please send us the application form so we can match you with a volunteer professional psychologist to call you for support and psycho-education. 
Service will be provided through phone or online metaverse and is free. Current language service will be limited to English. Our service time is 9-21 everyday, and would run till Jan 31, 2023.
Sign in to Google to save your progress. Learn more
Do you prefer using English? *
Please give us your phone number. (This is to inform you your appointment schedule) *
Please add you Email address.  (This is to inform you your appointment schedule) *
Please give us your available time, so we can match with an available psychologist.
(ex. Wed 3:00~6:00 PM)
*
[Agreement form] I agree on giving my phone number and email address to receive this psychological consultation service. These information will be deleted soon after the end of service use. *
Based on your application we will confirm the consultation schedule and inform you ASAP by text and email.
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy