Spectra Covid-19 update

Young Person Counselling Registration form


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

If you are completing this form for someone esle, please make sure you have the yound person's consent to submit their information.

Applying on behalf of someone else?

If you are applying for someone else, please tell us your name, relation to the client and your contact detail. Or is there anything else we should know about this application?


About you (the young person)


Can we contact you via...

Is your GP aware of your gender identity?


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


In order for us to be mindful of any conflict of interest please could you tell us if you know any staff at Spectra, are in a close relationship with someone who has applied to/ is receiving counselling from Spectra. Or if you are receiving counselling elsewhere.

Your Availability

In responses to the current Covid-19 pandemic, all our counselling sessions will be provided online or over phone call. We hope to resume Face to Face counselling in the future and we will use your indication to allocate you a slot in your chosen location once this is available.

Please Choose from:
St Charles' Centre for Health & Wellbeing, 1pm-7pm, Monday to Friday;
56 Dean Street, 4pm-7pm, Wednesday

REASONS FOR SEEKING COUNSELLING


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

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

ADDITIONAL SERVICE

Pyramid Youth LGBTQI+ group

StudentSpectra's Youth Group -Pyramid - is for 13-18 year olds who live in London and identify as LGBTQ+ who want a space to socialise with other LGBTQ+ peers, and to find support with their mental wellbeing, identity, and personal development.


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