Make an Appointment (Self Referral Form)

Before we can set up your first appointment, we would ask you to fill out a self referral form. You can print out this paper form then fill it out, sign it, and scan / email or post or drop it to us. In order to protect your confidentiality we do not need you at this stage to disclose the reasons you wish to attend.

On receipt of your information, we will add your name to our waiting list and you will be offered a first appointment as soon as one becomes available. If you cannot attend this appointment it is very important that you let us know as soon as possible, so we can offer your appointment time to someone else. Of course, we will be very happy to rearrange your appointment for a more suitable time.

The full cost of each session is €60 however Cork Counselling Services operates a sliding scale so as to make the service available to all. A lack of money should never stop you from coming to counselling.

Please note that if you are coming for counselling for yourself, it is not suitable to bring children with you.

If a child attends counselling, the first appointment be with parents / guardians.

We want to protect your privacy so if you are attending for individual counselling we are unable to see others who have a close relationship with you (eg. family, friend, work colleague etc.)

Again, to protect your privacy, be aware that geo-location services on your mobile phone may inform others when you are visiting our service. Remember you have the choice to turn these services off.