Julia Scott Counselling

Waiting List

Please leave your details below and I’ll let you know as soon as I have a suitable space.

Name * Required

Email * Required

Phone

Therapy * Required

Therapy mode (Face to face / online) * Required

When can you be available for therapy? * Required

Please provide your preferred days / times and any days / times you can’t do

Age declaration * Required

I am aged 18 or over

Consent

I agree to submitting this data to Julia Scott for the purpose of managing the waiting list