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BEFORE YOUR FIRST SESSION

Client registration

If we've spoken and agreed to start working together, please fill in this form before your first session. It only takes a few minutes, and it helps me get everything ready for you.

Not been in touch yet? Please get in touch first and I'll reply to arrange your first session or a free consultation.

Your details

Step 1 of 4

About you

The basics, so I know how to reach you.

Date of birth
Day
Month
Year

Is it OK for me to leave a voicemail or send a text? *

Some people share a phone or prefer discretion. I'll only ever say it's Carey, never what it's about.

Communication Preference
Yes, either
Texts only
Voicemail only
No, email only

Step 2 of 4

Emergency contact and GP

I'll only contact these people if I'm seriously worried about your safety, and wherever possible I'll talk to you first.


Step 3 of 4

Your counselling

All optional. Share as much or as little as you like. We'll talk properly in our first session.

How would you like to have sessions? (optional)
In person, Leigh-on-Sea
Online by WhatsApp video
Telephone
Not sure yet

For example, weekday afternoons or after 5pm on Tuesdays.

A line or two is plenty.

Have you had counselling or therapy before? (optional)
Yes
No
Prefer not to say
Are you currently seeing another counsellor or mental health service? (optional)
Yes
No

Step 4 of 4

Nearly done
How did you find me?

Our counselling agreement. Before we start, please read my Terms & Conditions. They're our counselling agreement and cover fees, cancellations, confidentiality and its limits, and what to do if you need urgent help.

This form isn't checked for urgent messages. If you need help right now, call NHS 111 and choose the mental health option, or Samaritans free on 116 123.

What I'll ask for

Your contact details and address, and a few questions to help me prepare for our first session.

Your information is safe

Your details go straight to me and are stored securely. Only I can see them. See my Privacy Policy.

What happens next

I'll confirm the time of your first session, which is on me, and answer any questions you have.

Need a hand, or prefer a paper copy? Call 07826 774307 or email carey@therapycare.co.uk and I'll send one to bring along.

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