PsychologyOnline offers psychological treatment, counselling and therapy with Chartered Psychologists for people suffering from illnesses such as stress, anxiety, panic, phobias, anger and depression.

 


 



You may be unsure about the nature of the difficulties you are experiencing and whether or not treatment is available for them. If so, you can enter your details in the box below. A therapist will then reply to your e-mail within 48 hours. (nb. We cannot reply if you do not include your e-mail address).

1. Your name

2. Your e-mail address


3. General description of difficulties

Note: Please try to fully complete the boxes below to enable us to assist you as much as possible.

4. Describe as many of the symptoms as you can below.

5. When did first start to experience these symptoms.

6. How often do the symptoms occur.

7. In what situations do the symptoms become more difficult to manage.


8. How have your difficulties affected your homelife, work and social life.


9. If you have any other comments you would like to add, please do so below.



When you have completed the boxes as thoroughly as possible please click the submit button below. (You may wish to print off this page to consider your replies and then return to fill in and submit the form).

 

 

Please note: Our service is not suitable for people with a history of mental illness, which requires the continuation of existing professional relationships.
Also, if you are experiencing, or have in the past experienced serious thoughts about taking your own life, we are not an appropriate service. Please contact your GP or telephone the Samaritans (08457 90 90 90).

 

 

 

 



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