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WAITING LIST CONTACT FORM 

 

By selecting to submit the contact form below, you have opted to be

placed on LTR's waiting list for the next available counsellor.

To select a therapist of your own choice please visit the Therapist Page.

Once you submit this form you will receive a response with-in 7-10 days.

An available therapist will contact you to arrange a suitable time for a

consultation call whereby arrangements for an appointment can be made directly

with your therapist.

If you are filling in this form on behalf of someone else, please ensure you have gained their consent

and that you enter their contact details.

I am enquiring about
Please select your therapist preference:
I would like my appointment to be...

Thank you, your form has been submitted.

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