Book Therapy Sessions

Name *

First

Last

Email *

Cell number (please include area code) *

Type of therapy you are interested in? *

Individual therapy
Couple's therapy
Long-distance couple's therapy

Partner's name (couple's therapy clients only)

First

Last

Partner's email (couple's therapy clients only)

Name of emergency contact *

Email address of emergency contact *

Timezone *

If yout timezone doesn't appear on this list, please include it in the space provided under 'Other concerns that you'd like Donna to be aware of' at the end of this form.

Please indicate which day/s would suit you best for weekly sessions. *

Please indicate what time of day would suit you best for sessions. *

Morning
Afternoon

Donna will do her best to accomodate you when replying to this with her available time-slots.

Please indicate whether you will be continuing with online or in-person therapy. *

online therapy
In-person therapy

All online sessions are done using Zoom. In-person sessions are conducted at Donna's home office in Fulham, London.

Please provide a brief summary of what you are wanting to work on in therapy. *

Please include any other concerns that you'd like Donna to be aware of.