Online Referral Form

We specialise in suicide bereavement but we also work with other issues around managing wellbeing and poor mental health. We support adults and young people.  

We offer a limited number of complimentary counselling sessions, however due to the lack of funding available, it is not long term therapy.  We are able to offer continued counselling at a low fixed rate of £15 per session after the agreed number of complimentary sessions have ended.

To help us to give you the most suitable advice and support, please outline as much information as you can when completing your referral.  We do need you to provide as much detail as possible. Blanks forms will not reach us.

If you are completing this form on behalf of a patient you must state your name and contact details, or this will not be accepted.