Self Referral Form

NEECS aims to protect the confidentiality of all clients at all times. By providing details on your 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 that when NEECS offers its appointments matches your availability to attend (see below)

We are unable to advise how long you will have to wait for an appointment with us however please be assured we will offer you an appointment as soon as we are in a position to do so. After your initial appointment your following counselling appointments will be at the same time, on the same day each week  For further possible sources of help click the Directory link. For a longer list email us via the Get in Touch link. Please note our limited (Thursday) evening sessions are heavily oversubscribed.

Mondays: 9am to last appointment 12.45pm
Tuesdays: 9am  to last appointment 4.30pm
Wednesdays: 9am  to last appointment 12.45pm
Thursdays: 2.45pm  to last appointment 6.45 pm
Fridays: 11.30am to  to last appointment 12.45pm

The Short Term Service and Core Service Waiting List are closed, and will be reviewed in January 2019. 


All NEECS staff comply with NEECS Confidentiality and Privacy Requirements.