Lacap The London Association for Counselling and Psychotherapy 

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Please only use this form if you are applying at standard fees!
You can expect us to respond by booking in an appointment for you.
This means that you are asking us diarise a meeting with a consultant that may often be at less than 7 working days notice.
 

first name:   
last name:   
email address:   
mobile number:   
home number:   * Not Required
work number:   * Not Required
date of birth:       
address: house no  
  street name  
  post code    
Call ok?  Yes No

Email ok?  Yes No
Email Application for Therapy 1/3
 

 
 

Individual Therapy Couples Therapy Email Enquiry Contact Details Client Logon

Information Menu
Home
About Appointments
About us
Our Fees
Where we are
List of Therapists
What is Therapy?
Tell a friend
GP Referral Info
Client Logon
First Meetings
Apply to Join
 

For the initial consultation, please indicate days and times that are usually possible for you to make on an ongoing basis. We will try to meet those
times requested, but for the first meeting might ask you to be a little more flexible about attending.We will arrange an initial consultation based on the information you have supplied, so please do be careful to enter the correct information for us.

My available days are:FirstLast
Monday  Yes No
Tuesday  Yes No
Wednesday  Yes No  
Thursday  Yes No
Friday                Yes No 
Saturday  Yes No 
Sunday               Yes No
Email Application for Therapy 2/3
 

Tell us more about your possible times!

 

 
 

Individual Therapy Couples Therapy Email Enquiry Contact Details Client Logon

Information Menu
Home
About Appointments
About us
Our Fees
Where we are
List of Therapists
What is Therapy?
Tell a friend
GP Referral Info
Client Logon
First Meetings
Apply to Join
 
Please tell us your preferences & circumstances

I would prefer to see:

Only a male therapist
Only a female therapist
I have no preference

 
 
I am telling you my income 

Yes No

My annual gross income is

 

NOTE !  You are applying at standard fee rates. If you let us have a note of your annual gross income, we can let you have a note of the cost of the initial consultation & ongoing meetings. You do not have to tell us about your income, but without your income declaration, the initial consultation fee will be 50.00.
*** If you want help with fees use the Online Application form ***

  Email Application for Therapy 3/3

 

Services that are to be provided within 7 working days. We should always offer meetings to you as soon as possible, unless you indicate that we should give you a longer period to decide and reflect. That means that there may often be less than seven working days between us notifying you of an appointment and the appointment time itself.  You are agreeing that the service may start before the end of the Consumer Protection Act cooling-off period. All our initial appointments, though, allow a 48 hour notice of cancellation without charges to you, or if made within that 48 hour period, the automatic right to reschedule that meeting to a later time in the next 30 day period. Late cancelled, or unattended meetings may be charged by us.

 
 

I do NOT want my appointment to be
scheduled in the next 7 working days

 

Thank you for your application.
Please post it to us using the 'send' button below.