Please fill out this form to provide your emergency contact details and confirm that you have read and understood the terms of our Therapeutic Agreement.

As part of my duty of care towards you, it is important I capture important safeguarding information like your chosen emergency contact, GP details and address so that I am able to access the correct support for you if a crisis arises during our sessions.

All information captured in this form is securely stored and would only ever be used in case of emergency. If you have any questions about how I handle data, please feel free to ask.