Counselling Questionnaire

Thank-you for booking a consultation with us

Below is our client questionnaire and agreement this must be filled in prior to the consultations,  if you do not have time to fill out the form today you will also receive a link to this questionnaire via an email from us.

We will be in touch very soon to schedule our time together.  Please remember to fill out the form before our consultation.

We Need Some Info to Help You

Please fill out the following questionnaire. At the end there is space to tell me as much as you like about the issues that you would like to consult about.

Please don’t be put off by the length of the Questionnaire; most of the questions are answered with a yes or a no. The more detailed the answers the better the help that can be provided for you with the best possible service.

Before filling out the questionnaire, a reminder : you must be over 18, and you must have read the legal & privacy agreementsPayment must also be made before you can submit your questionnaire


Thank you for answering these questions, your answers will help me to offer you the best counselling I can I will be in touch when I have read your answers to arrange your next message 

Ron Gathercole

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