Please download and complete this questionnaire, which will provide us with a snapshot of the difficulties you are currently experiencing. To complete the form, use the drop-down boxes to tell us how much each statement applies to you. Please think about how life has been for you over the past week only.
Next, download and fill in the GP’s Details and Consent form (You will need to click ‘enable editing’ at the top of the screen after downloading the form to your computer). We need this information from all our clients just in case we come to have serious concerns about your safety or wellbeing. We also ask you to tell us about a person we can contact in an emergency. Don’t worry if you aren’t able to sign it, your reply via email counts as confirmation of this agreement.
Please note: Cogwheel has rigorous standards of IT security, and your data is protected in line with GDPR requirements. However please be aware of the theoretical but small risks generally associated with sending personal data via email.
Send your completed forms back to us at firstname.lastname@example.org as soon as you can. We may contact you to arrange a phone-call with one of our counsellors to talk through your responses to the questions. This can help us to decide with you whether remote counselling is right for you. If we think that another service would suit you better, we will do our best to help put you in touch with alternative support.
Once you have returned your forms and if we think remote counselling at Cogwheel will be helpful for you, we will contact you to arrange an assessment. You can read more about ‘Your assessment appointment’ here.