Full Name

Email Address

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Landline Number

Select how you would like us to contact you: Select how you would like us to contact you: By Email By Mobile Phone By Landline Phone By SMS / Text Message

Select where we can leave a message if you're unavailable: Select where we can leave a message if you're unavailable: Landline Answerphone Mobile Voicemail SMS / Text Message Email Message

Who you are enquiring for? Who you are enquiring for? For myself For a friend, relative or colleague For myself, I'm a trainee counsellor / psychotherapist For myself, I'm a counsellor / psychotherapist

What service are you enquiring about? What service are you enquiring about? Psychotherapy / Counselling Only EMDR Only Psychotherapy & EMDR Combined Clinical Supervision

Please tell us about the difficulties you are experiencing and what you would like to achieve from Counselling / Therapy / EMDR.

Please tell us the requirements you have for Clinical Supervision.

Please tell us more information about the person you are contacting us about.

Where would you like to have sessions? Where would you like to have sessions? Online sessions In person sessions in Market Harborough Some online, some in person sessions

What day(s) can you attend sessions? What day(s) can you attend sessions? Mondays Tuesdays Wednesdays Thursdays

Mondays - Select earliest start time Mondays - Select earliest start time *Monday start - 9:30amMonday start - 10:30amMonday start - 11.00amMonday start - 12.30pmMonday start - 1.30pmMonday start - 3.00pmMonday start - 3.30pmMonday start - 4.30pm

Mondays - Select latest end time Mondays - Select latest end time *Monday end - 10:30amMonday end - 12.00pmMonday end - 12.30pmMonday end - 1.30pmMonday end - 2.30pmMonday end - 3.30pmMonday end - 4.00pmMonday end - 4.30pmMonday end - 5.30pm

Tuesdays - Select earliest start time Tuesdays - Select earliest start time *Tuesday start - 9:30amTuesday start - 10:30amTuesday start - 11.00amTuesday start - 12.30pmTuesday start - 1.30pmTuesday start - 3.00pmTuesday start - 3.30pmTuesday start - 4.30pm

Tuesdays - Select latest end time Tuesdays - Select latest end time *Tuesday end - 10:30amTuesday end - 12.00pmTuesday end - 12.30pmTuesday end - 1.30pmTuesday end - 2.30pmTuesday end - 3.30pmTuesday end - 4.00pmTuesday end - 4.30pmTuesday end - 5.30pm

Wednesdays - Select earliest start time Wednesdays - Select earliest start time *Wednesday start - 9:30amWednesday start - 10:30amWednesday start - 11.00amWednesday start - 12.30pmWednesday start - 1.30pmWednesday start - 3.00pmWednesday start - 3.30pmWednesday start - 4.30pm

Wednesdays - Select latest end time Wednesdays - Select latest end time *Wednesday end - 10:30amWednesday end - 12.00pmWednesday end - 12.30pmWednesday end - 1.30pmWednesday end - 2.30pmWednesday end - 3.30pmWednesday end - 4.00pmWednesday end - 4.30pmWednesday end - 5.30pm

Thursdays - Select earliest start time Thursdays - Select earliest start time *Thursday start - 9:30amThursday start- 10:30amThursday start - 11.00amThursdays start- 12.30pmThursday start - 1.30pmThursday start - 3.00pmThursday start - 3.30pmThursday start - 4.30pm

Thursdays - Select latest end time Thursdays - Select latest end time *Thursday end - 10:30amThursday end - 12.00pmThursday end - 12.30pmThursday end - 1.30pmThursday end - 2.30pmThursday end - 3.30pmThursday end - 4.00pmThursday end - 4.30pmThursday end - 5.30pm

If we have a full case load, we operate a short waiting list which we have to close from time to time to keep it manageable. We are trialling holding a mailing list where we can notify people that we either now have availability, or have spaces available on the waiting list. Please let us know If we have a full case load, we operate a short waiting list which we have to close from time to time to keep it manageable. We are trialling holding a mailing list where we can notify people that we either now have availability, or have spaces available on the waiting list. Please let us know Add me to the waiting list if there is no immediate space Add me to your mailing list if your waiting list is closed No thanks, I'm not able to wait

How did you find our website? How did you find our website? *Google SearchPsychology TodayCounselling DirectoryInsurer eg Bupa / WPA / Vitality HealthBACP DirectoryUKCP DirectoryBAATN DirectoryFindatherapy.orgA friendA relativeOther