Time to contact me…

…to book a no obligation Counselling/ Psychotherapy consultation or make an enquiry about supervision or training.

I work in North Lincolnshire in a non clinical setting which is accessible and has parking on site. I have disabled access to both therapy and training rooms and access to a ground floor toilet. I have daytime and evening appointments available, Tuesday, Wednesday and Thursday.

I am concerned to protect the privacy of children aged 16 or under. If you are aged 16 or under‚ please get your parent/guardian’s permission beforehand whenever you provide me with personal information. For your information, I do not work with clients aged 18 or under.

Name

Telephone number

Email address

Message

Do you consent to receiving information from me about my services? Do you consent to receiving information from me about my services? Yes No

Phone/Email/Post/Text Phone/Email/Post/Text Phone Email Post Text

Do you wish me to contact you to inform you of future news on therapy/supervision/training opportunities? Do you wish me to contact you to inform you of future news on therapy/supervision/training opportunities? Yes No

Phone/Email/Post/Text Phone/Email/Post/Text Phone Email Post Text

Number

10 + 12 =

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07831 834110

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01652 655454

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jan@therapyworks4u.co.uk

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