Intake & agreement

One form, and we're ready to begin.

This is your intake form and your counselling agreement in one place. Most of it is optional — answer what you're comfortable answering, and leave the rest for session. Everything here is confidential, encrypted in transit, and read only by your counsellor. LGBTQIA+ affirming by default: nothing about your identity, relationships or body needs explaining or defending here.

About you

The essentials so I know who I'm meeting.

Health and safety

Kept for your safety only. If anything here is difficult to write down, leave it blank and we'll talk.

Next of kin / emergency contact

Contacted only in a genuine emergency. You choose who this is — chosen family absolutely counts.

A few quick questions

Six taps, and they genuinely shape how this practice grows. Skip any of them.

Your counselling agreement

Read each section and tick to confirm. This is the whole contract — there is nothing else to sign.

Fees and payment

Sessions are 50 minutes. The standard rate is £95 per session, with reduced per-session rates in blocks of four, twelve or twenty-four. Payment is made in advance — a session is only held once payment has cleared. Blocks can be ended at any time: attended sessions are charged at the standard £95 rate and the remainder is refunded.

Cancellation and attendance

For your first paid session you can cancel or move free of charge up to 24 hours beforehand. From your second session onwards the window is 48 hours. Inside that window, and for missed sessions, the full fee is charged. If I ever need to cancel, that session is rescheduled or refunded in full.

Confidentiality

What you bring to session stays between us. Notes are brief, kept securely, and are not shared with employers, family or partners. I work in clinical supervision as required by the BACP; your material may be discussed there anonymously.

Limits of confidentiality

There are narrow exceptions: serious and imminent risk to your life or someone else's, risk to a child or vulnerable adult, certain legal disclosures required by law, or a court order. Wherever possible I will talk to you first.

Records and your data rights

The Great Thriving LTD is the data controller (ICO registered). Health information is special category data, processed on the basis of your explicit consent and for the provision of healthcare. Records are retained for seven years after our final session and then deleted. You can request a copy, correction or erasure of your data at any time.

Working online

Sessions take place by secure video. Please join from a private space with a reliable connection. If we lose connection we will reconnect, or continue by phone. Sessions are never recorded.

The agreement as a whole

You can end counselling at any time; an ending session is usually helpful. I may suggest a different service if what you need falls outside my competence. Contact between sessions is for scheduling only.

Consent and signature

Typing your name below has the same effect as signing it.

Signed 30 July 2026. A copy is emailed to you on submission.

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