Name *

First Name

Last Name

How would you like to work with us?

Online

Face-to-face

It is important to have a consistent therapy slot to ensure progress and stability. When would you be available for sessions?

Evenings

Afternoons

Mornings

Only weekends

How did you hear about us?

A friend told me

Instagram

Facbook

I saw an ad

I went to an event

I was searching for neurodivergent/queer therapy

I was referred y a therapist or resource centre

*

By ticking this box, you confirm that you have read, understood, and agree to abide by our Safety and Respect Policy. Violations of this policy may result in the termination of services at the discretion of Violet Psychology. You can find and read the policy at the bottom of the page.