9 Orme Court
London W2 4RL
How we work
I Need A Placement
About placements at Help
How to apply
What is a placement like at Help?
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Date of Birth (DD/MM/YYYY)
Address Line 1
Address Line 2
GP Practice Name
GP Address line 1
GP Address line 2
GP Telephone Number
Have you ever been in the care of a Psychiatrist? If 'Yes' please provide detail of this care, if 'No' please state 'No'
Have you ever had a formal Psychiatric Diagnosis from a Psychiatrist (not a GP)? If 'Yes' please provide details, if 'No' please state 'No'
Why would you like to have counselling? What are the things you would like to talk about?
Have you had any counselling or therapy before? If so, please give some details.
Medication: please select any medication you might be taking for anxiety, depression or any other mental health diagnosis
If you selected 'other' in the medication section above, please list your medications here:
Availability - Sessions will take place with your Counsellor at the same time, on the same day each week. We are unable to reschedule sessions so please only provide availability for times you will be able to attend regularly.
Monday AM From 10:00-12:00
Monday PM From 13:00-16:30
Monday Evening From 17:30-19:30
Tuesday AM From 10:00-12:00
Tuesday PM From 13:00-16:30
Tuesday Evening From 17:30-19:30
Wednesday AM From 10:00-12:00
Wednesday PM From 13:00-16:30
Wednesday Evening From 17:30-19:30
Thursday AM From 10:00-12:00
Thursday PM From 13:00-16:30
Thursday Evening From 17:30-20:30
Friday AM From 10:00-12:00
Friday PM From 13:00-16:30
Friday Evening From 17:30-19:30
Payment - We operate a two pricing system , if your household income is below £35,000 a year you can access the services for £25 per session. All assessments are charged at £25
£25 per session
£40 per session
I have read, understand and agree with Help GDPR policy statement
It is the aim of Help Counselling to be fully compliant with current GDPR
Legislation. GDPR replaces the previous Data Protection Act and we intend in
this policy to be transparent, with regard to the processes we have
in place. Identifiable information, if shared, will only be used in accordance
with this privacy statement. We follow guidance from the British Association
for Counselling and Psychotherapy and our insurers, Howden.
Help Counselling is the data controller and as such, is responsible for your
personal data. We are registered with the Information Commissioner’s Office
(ICO) and have appointed a Data Protection Officer (DPO). If you have
your legal rights, please contact the DPO, via the email address below:-
If we cannot resolve any matters of
interest or concern, then you can also contact the ICO directly.
As the data controller, Help Counselling will collect and process some of your
personal data, including any data you may provide through our website when
making a self referral and when you book and attend an assessment. As part
of their work, Help counsellors keep brief, factual content notes of
each session, which are anonymised and held securely for seven years. After
this period these notes will be disposed of securely.
Data processing means obtaining, recording or holding information.
Help Counselling undertakes to hold all sensitive data safely and securely.
This involves anonymising information and using passwords, codes and
encrypted documents. You have a right to see the information that Help
Counselling holds about you, you can also withdraw consent at anytime or
ask Help Counselling to delete any of the data that we hold, however there
are some details that we need to keep due to legal and professional
other privacy, confidentiality or fair processing policy, we may provide when
we are collecting or processing personal data about you. Doing so will ensure
that you are kept informed of how and why we are using your data. This
privacy policies and is not intended to replace or override them.