Application for Psychosocial Counselling
Hello.
Based on the current epidemic of Coronavirus and the distress that is connected with it, the Psychologists with Bachelor degrees and postgraduate students of psychology decided to organize free counselling. The counselling is carried out by volunteers and lasts up to 45 minutes. We would like to stress that we will only be providing the support for the current situation and we will not be able to focus on your other burdens. This is because we are providing a shortened form of counselling. Occasionally we will be obligated to redirect an application on to more qualified counsellors. We thank you for your trust and your search for a mature way of coping with problems. We ask you to fill out the following survey, which will enable us to invite you to counselling with one of our counsellors. After you have submitted the survey you will be contacted by one of our counsellors through email. Together you will agree on a time and type of online meeting. After counselling you will be asked to fill out a short survey.
Thank you for your trust
Team @psiho.dezinfekcija
e-mail: *
Gender *
Age: *
Which problems are you facing *
Required
Mark with Yes or No
Yes
No
I feel a bigger distress than usual, i could use some help e.g. Information, advice, etc.
I am in such distress that i can barely cope with it or that i cannot manage the problems that i have.
I have suicidal thoughts.
I often cannot control my anger.
I am often under influence of drugs or alchohol.
I have traumatic memories of past events.
Clear selection
GDPR Provisions: In accordance with GDPR and PDO, " The Coronavirus Psychosocial Support Initiative " will use this information for the purpose of communicating with the counsellor, connecting the counsellor and the user, and submitting a final questionnaire. At the beginning of data processing, the e-mail will be separated and the data will be secured with a code. For the purpose of keeping statistics, your data will be accessible under a code, which allows complete anonymity. The Coronavirus Psychosocial Support Initiative will, in accordance with applicable law, retain your personal information until terminated by you. We are committed to processing your data in accordance with the applicable European Union General Data Protection Regulation by taking the appropriate steps to ensure adequate security. You may withdraw your consent to the processing of the data at any time or request additional information by emailing us at psiho.dezinfekcija@gmail.com. The data will also be used in a survey related to the evaluation of counselling during a social distancing. Please indicate below before you submit the form, whether you agree to the collection of your personal information. Unless you agree with the processing of the data, we are unfortunately unable to offer advice due to systematization and quality assurance.Team @psiho.dezinfekcija * *
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