Soul Synergy Therapy Referral Form
Please complete the following form. You will hear back from us within 2 working days.
Note: Soul Synergy Therapy will store information that is collected for the benefit of your inquiry. If you decide not to proceed for counselling with Soul Synergy Therapy, all your personal data will be deleted within 2 weeks. This information is for records purposes only and remains confidential unless given consent by you, the client. Exceptions to confidentiality are extreme circumstances where there might be threat to life or information about fraud or terrorism, in which case information will be passed on to the appropriate authorities.