Presbyterian Counselling Associates - PCA  长老会心理咨询师协会  - PCA
We are a team of professional counsellors and therapists who are members of local congregations of The Presbyterian Church in Singapore.  
我们的团队是由专业心理咨询师和心理治疗师组成的，我们都是新加坡长老会教会的成员。

Our counselling services are open to members of the Presbyterian churches and their families and friends at the rate of $140 per session (60 mins) for individuals/couples.

我们的咨询服务向长老会成员及其家人和朋友开放，费用如下: 个人配偶和家庭每节 $140(每节 60 分钟) 

*There is a no-show fee of $30 (appointment is not cancelled/postponed 24 hours before scheduled time)
*缺席费为 $30（预约不会在预定时间前 24 小时取消/推迟）
Please fill in your details and we will contact you shortly. 
All information you provide here will be strictly confidential to PCA.  
请填写您的详细信息，我们会尽快与您联系。 您在此处提供的所有信息将对 PCA 严格保密。

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Name  姓名 *
Mobile phone number  手机号 *
Email address  电邮地址
Residential address and postal code  住宅与邮编 *
Gender  性别 *
Age  年龄 *
Marital Status  婚姻状况 *
Brief description of your issue  问题的简要描述 *
Are you a member/regular attendee of a Presbyterian church? If yes, please indicate name church. (If not, please leave blank)  您是长老会教的成员/定期参与者吗？如果是，请注明教会名称。（如果没有，请留空）
Are you referred by someone? If yes, please indicate person's name and church. (if not, please leave blank)  您是由某人推荐的吗？如果是，请注明姓名和教会。（如果没有，请留空）
Preferred Language (if other than English)  
首选语言（如果不是英语）
Preferred counsellor (if any)  首选顾问（如有）
Please indicate if you need subsidy. This applies only if you are a student, missionary, church worker, or your income is less than $3000 per month (verification may be required).   请注明您是否需要补助. 此项仅适用于学生、宣教士、教会同工，或每月收入少于 3000 元者.
(可能需要提供核实)
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Terms & Conditions (T&C1) - I give permission to Presbyterian Counselling Associates to collect, use and disclose my personal data provided here for the purpose of organizing my request for counselling. I understand that this data may be stored on an external application in the cloud. 条款和条件 (T&C1) - 我允许PCA收集、使用和披露我在这里提供的个人数据，以便组织我的咨询请求。我了解此数据可能存储在云中的外部应用程序上。 *
Required
Terms & Conditions (T&C2) - I accept that all counselling sessions will be conducted in a professional manner and kept confidential with my counsellor. I will not hold my counsellor, or any referral person, or any church, or organisation responsible or liable for any of my personal actions, decisions and/or well-being in and/or outside of counselling sessions.  
条款和条件（T&C2） - 我接受所有的咨询都将以专业的方式进行，并与我的咨询师保密。我不会追究我的咨理，或任何推荐人，或任何教会，或 对我在咨询期间和/或外部的任何个人行为、决定和/或福祉负责或负责的组织。
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