请仔细阅读以下条款，填写本申请表即表示您同意以下条款，并知悉华人协会对此项目有最终解释权。

1. 填写下表即表示您同意我们将您转介给符合您需求的专业心理辅导师，与您进行联系。咨询服务采取远程连线的方式（视频或电话）。

2. 我们对您填写的信息严格保密，只与此服务相关人员分享，除非涉及法律特殊要求。

3. 您保证填写的内容是您的真实资料。

Please read the following terms carefully. By filling out this application form, you agree to the following terms and know that Chinese in Wales Association (CIWA) has the right of final interpretation.

1. By filling out the form below, you agree that we will refer you to the professional counsellor and the counsellor will contact you discussing or arranging therapy sessions. The counselling service takes the form of remote connection (video or telephone).

2. We keep the information you provided strictly confidential, and only share it with personnel related to this service, unless it involves legal requirements.

3. You confirm that the information you provide is your true information.