Thank you for exploring counselling with Tilia Therapy.  Please complete the following form so we are able to arrange an initial consultation. Completion of this form does not guarantee an immediate match with a therapist. If you have any further questions, please don't hesitate to get in touch with Ali Xavier: ali@tiliatherapy.co.uk

When you contact us with an enquiry about Tilia Therapy we will collect information to help us satisfy your enquiry. This will include your basic contact details, GP details, and an emergency contact. (You might wish to inform your emergency contact that you have provided their details to us). This information is for our records & remains confidential, unless authorised by you the client, except in extreme circumstances, such as threat to life or information about terrorism or fraud. 

If you decide not to proceed with counselling we will ensure all your personal data is deleted within two weeks. If you would like us to delete this information sooner, just let us know.