Nacre Therapy Referral Form

Thank you for exploring counselling with Nacre Therapy.  Please complete the following form as best as you are able, so we can then arrange an initial consultation. If you have any questions, please don't hesitate to get in touch with nacretherapy@proton.me.

When you contact us with an enquiry about Nacre 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 may wish to inform your emergency contact that you have provided their details to us). This information is for our records & purposes only and remains confidential, unless given consent by you, the client. Exceptions to confidentiality are in extreme circumstances where there may be a threat to life or information provided about terrorism or fraud, in which case any necessary details will be passed on to the appropriate authorities.

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, please just let us know.

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