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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.

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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.

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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.

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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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