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. If require any help completing the form please call us on 07498 520 377.

We are not able to say how long you will have to wait for an appointment, but be assured we will be in touch as soon as possible. The waiting ltime will also depend on your stated availability.

During Covid_19, NEECS offers counselling during the folowing times........

  • Mondays: 9.30am to 4pm (last appointment)
  • Tuesdays: 9.30am to 4.30pm (last appointment)
  • Wednesdays: 9am to 12.45pm (last appointment)
  • Thursdays: 4pm and 5.30pm only
  • Fridays: 10am and 11.30am only

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 other sources of help link on the home page. Or contact us by email, using the Get in Touch link. 


All NEECS staff comply with NEECS Confidentiality and Privacy Requirements.