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Name

First Name

Last Name

What would you like me to call you?

Preferred pronoun

In-person or Remote

Town / City

Email

Information

What would you like me to know about you and your decision to explore therapy?

Availability

Please list your availability within 9am–3pm, Wednesday–Friday

Confirmation

I am aware the session fee is £90 and can confirm this is affordable to me. (This is not a commitment to starting therapy)

Contact