Spectra Covid-19 update

Counselling Registration form

If you need any support to complete this form, please contact us via counselling@spectra-london.org.uk


About you


Can we contact you via...


Is your current gender identity same as you were assigned at birth?




REASONS FOR SEEKING COUNSELLING




PLEASE LET US KNOW IF ANY OF THE FOLLOWING ARE/HAVE BEEN A CONCERN for you...

This could include but is not limited to: physical abuse; emotional abuse; sexual abuse; domestic abuse; neglect.



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