Counselling and Support referral
We now have a single referral form for the services we provide to adults, young people and children.
Please note that we aren’t able to provide support for Depression, Anxiety or Stress for children unless this is related to a Bereavement/Loss, Family Breakdown or Domestic Abuse.
You can use the form below for:
- Counselling, if you live in, are registered with a GP in, or attend a school in the Metropolitan Borough of Knowsley.
- Referrals to our support service for those bereaved during the coronavirus pandemic if you live in or are registered with a GP in South Yorkshire. Although this is not a counselling service, it is provided by trained counsellors.
- Counselling referrals for CYP Bereavement/Loss, Family Breakdown or Domestic Abuse for the Wirral & St Helens areas.
- Counselling referrals to our VIDA Occupational Health service for clients in or outside of the borough of Knowsley. If referring under our VIDA service please ensure that you include your employers details for invoicing purposes.
If you do not meet any of these criteria, and / or you would like to make a referral to our private clinic, please visit this link to see details of our charges and referral form.
If you have any queries about our referral process or if you need help completing the form, please contact us for assistance.
You can download a copy of Listening Ear’s Privacy Notice here. This contains information on why we collect your information, what we use it for and your rights in relation to your data. To request access to your personal data, a correction or deletion, please complete this form and return it to us using the details provided.