Before your first session, we need to gather some basic information from you. All of the information provided by you on this form will be treated in the strictest of confidence and will not be shared with anyone without your express permission. Our privacy policy can be read here.

We appreciate the time you are taking to complete this form. If you are unclear on any of the questions then please contact us for help.

Any field with marked with a red asterisk (*) is a required field, and the form can only be submitted when these have all been completed.

Many thanks,

Chris O’Brien