Self Referral Form

NEECS aims to protect the confidentiality of clients at all times. By providing details on our self-referral form, we consider this confirmation you agree to us using the details to provide you with the service requested. NEECS will only ever use your details for this purpose.  NEECS staff comply with NEECS Confidentiality Requirements.


Before completing this form it is important to check your availability to attend matches NEECS appointment times. 

We are not able to say how long you will have to wait for an appointment, but be assured we will do so as soon as possible, this is also dependent on your stated availability.

After your first appointment, all following counselling sessions will be at the same time, on the same day each week. 

For some further sources of help click the Directory link. A longer list is available by email, using the Get in Touch link. Please note thre is no availability for evening appointments

Mondays: 9am to last appointment 12.45pm plus 16-25 service only 12.15pm to last appointment 4.30pm 
Tuesdays: 9am to last appointment 4.30pm
Wednesdays: 9am to last appointment 12.45pm 
Thursdays: 2.45pm to last appointment 6.45 pm - there is currently no availability for evening appointments.
Fridays: 10.15am to last appointment 12.45pm 

All NEECS staff comply with NEECS Confidentiality and Privacy Requirements.