Menopause CBT Booking Form
To book an appointment, please complete the form below and we'll be in touch via email to arrange an appointment for you, or signpost you to a service that may be better able to meet your needs. If you have any queries, or would prefer to arrange a brief call to discuss your needs, please email us on enquiries@taywellbeing.co.uk

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Email *
Name *
Age *
Phone number *
Let us know the main reason you are seeking CBT and the sorts of difficulties you are experiencing *
Tell us about any coping mechanisms you have including any you think may help in the moment but ultimately leave you feeling worse. This can be things like: going for a walk, talking to a friend, listening to music, having a bath, drinking alcohol, smoking cannabis, under or over eating
Please let us know if there are any safety concerns we should be aware of, for example, self-harming behaviour or suicidal thoughts. Please note, there is information regarding accessing support in a crisis on our main website page *
Indicate below which location options you are interested in *
Required
Indicate which times of day/days of the week you would be available to attend appointments *
Let us know of any further information that it would be helpful for us to be aware of
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