Existing / New Client ---Existing clientNew client
Preferred Location ---Cleveland
Preferred Day AnytimeMondayTuesdayWednesdayThursdayFriday
Please note that all psychologists are not available all days
Preferred Time AnytimeMorningsAfternoonsAfter SchoolEvening
You may select more than one option
Type of Visit---Existing ClientAdult psychologistTeenager (over 13 only)Couples counsellingFamily counsellingOther
If you are a new client, please complete the following, so we can book you in with the most suitable psychologist for you
Gender ---MaleFemale
Age ---AdultTeenager 13 - 15Teenager 16 - 18
Additional Information
Please send us a message and we will get in touch.
