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Community Counselling Online Referral Form

***Waiting List for Brief Counselling in Scarborough, Filey and Whitby is now CLOSED***

We have, unfortunately, had to close the waiting list for brief (6 sessions) counselling in Scarborough, Filey and Whitby due to a lack of funding. Please do not use the Referral Form to refer a client or yourself to us if they live in these areas. We are working hard to secure new funding and will re-open the waiting list for these areas as soon as we can.
Please use the form below to refer yourself (or your client) to us. Please complete as much of the information required as you can.  We will get in touch with you as soon as possible. Please note that due to the current lockdown we are currently only able to offer online or telephone counselling. 

 

Personal Information
Address
Phone and Email
Details
Referrer Details
Medical Details
Appointment Preferences








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