Wellington Community Counselling Referral Form
Notes and Referral Process Summary
This form has been set up for use during the Coronavirus outbreak due to the lack of public access to GPs, PTFAs and other community support workers who would usually make the referrals.
If you have any questions prior to completing the form please get in touch by e-mailing firstname.lastname@example.org. We aim to respond within 48 hours.
Although our forms use secure and encrypted JotForm technology please keep any sensitive information for our follow up call.