Interested in booking a session? Open Form New Client Screening With all potential new clients, we like to do a short screening to find out a bit about you and your needs. It's totally free, and you have the option to complete the below form, or request to do it in person with one of our screening therapists. Please note: you are always welcome to reach out to therapists directly, via their profiles. I would prefer to complete this screening with a therapist I am going to complete this screening below Name * First Name Last Name Email * Phone Number * Date of Birth MM DD YYYY Reason for seeking therapy Aims/Goals for Therapy Your weekly Availability * Monday Morning Monday Afternoon Monday Evening Tuesday Morning Tuesday Afternoon Tuesday Evening Wednesday Morning Wednesday Afternoon Wednesday Evening Thursday Morning Thursday Afternoon Thursday Evening Friday Morning Friday Afternoon Friday Evening Saturday Morning Saturday Afternoon Saturday Evening Sunday Morning Sunday Afternoon Sunday Evening Preferred age range of therapist 25-35 36-45 46-55 55+ Any other preferences of therapist Type of Therapy What is recommended Cognitive Behavioural Therapy (CBT) Clinical Psychology Eye Movement Desensitization & Reprocessing (EMDR) Existential Integrative Humanistic Mentalisation-Based Therapy (MBT) Person-Centred Psychoanalytic Psychodynamic Transactional Analysis (TA) Transpersonal Budget * Please note, cost per session tends to reflect the therapist's training and experience. As a general guide: £50-£55= training therapists; £60-£70= newly qualified therapists; £70+ = experienced therapists; £120+ = psychologist £ Frequency of sessions Weekly Fortnightly Twice Weekly Preference Online Face to Face By Phone Medications Psychotropic only (for mental health conditions) Have you received a formal mental health diagnosis or have a suspected diagnosis? If yes to either, what diagnosis – indicating if formal or suspected. Any additional comments Thank you for your enquiry. We will be in touch shortly to arrange connecting you with a therapist.Best wishes,The Brixton Practice Team Interested in working with us? Open Form Submission of Interest Name * First Name Last Name Email * Phone * (###) ### #### I am * A Newly qualified therapist An Experienced therapist A Complementary practitioner A Trainee Therapist (interested in apprenticeship/placement) In Training (in training but signed off for private practice) Training * (Please indicate year if completed, or state active) Experience * Please tell us why you are interested in joining the practice * What does Relationality mean to you? * Anything else you would like to share Thank you for your email!We have variable office hours, but we will get back to you as soon as possible.Best wishes,Nathan, Trelawny & Gee
