Therapy Registration

Thanks for agreeing to begin therapy with me. Before we begin, I need some basic information about you so that I can make contact with you, if needed, and ensure our work is safe and supported. I am happy to answer any questions about why this information is needed, how it will be used and how long I will keep it for. Please be assured however, that all information will be held confidentially and only be used for the purposes of our therapy together.

We will not be able to start our sessions until this form has been received by me, fully completed.


By submitting the form you are confirming you have read, understood and are happy with the Agreements form sent to you separately, and are happy to begin therapy with me.  Additionally, that you understand I keep password-protected brief notes about our work together, which I am happy for you to have access to at any stage.