Student Counselling Service

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Book an appointment, a place on a workshop or join a group.

Email form

Personal details

Student no:

Have you been to counselling with us before?: Yes No

First Name:

Surname:

Date of birth:

Gender: Male Female Undergoing Gender Reassignment

Contact details

First line of address:

Postcode:

Tel/mobile no:

University email:

Additional information

Course of Study:

Year (e.g. 1st):

Nationality: UK EC Non-EC

Ethnicity: White Black Caribbean Black African Black Other Asian Indian Asian Pakistani Asian Bangladeshi Asian Chinese Asian Other White/Black Caribbean White/Black African White/Asian Other Mixed Arab

Other:

Sexual Orientation: Asexual Bisexual Heterosexual/Straight Gay Man Lesbian Queer Not sure Prefer not to say

Relationships/support

Please select all that apply

• Living alone
• Living with partner
• Caring for children under 5 years
• Caring for children over 5 years
• Living with parents/guardian
• Living with other relatives
• Caring for other adults
• Living in a shared house
• Living in a refuge/protected accommodation
• Living in halls
• Other

Service required

Please select which service you require; then select from the relevant options that follow; and then submit the email.

• Workshop
• Group
• Individual counselling

Options

Workshops

Please select which workshop(s) you would like to attend. [Note that places are limited.]

• 24 April - Self Esteem: The Mirror On Myself
• 1 May - Managing Exam Stress
• 8 May - Relaxation for Health and Wellbeing
• 22 May - Dragging your Feet

Groups

Please select which Group(s) you would like to attend. [Note that places are limited.]

• Relaxation for Health and Wellbeing - Mondays 6.00-7.00pm (term time only)
• Relaxation for Health and Wellbeing - Wednesdays 6.00-7.00pm (term time only)
• Relaxation for Health and Wellbeing - Fridays 12.30-1.30pm (term time only)
• Therapeutic Group 1 - Wednesdays 4.00-5.00pm (starting 1 May)
• Therapeutic Group 2 - Wednesdays 3.30-4.30pm (starting 15 May)
• Art as Therapy - Mondays 12.30-2.00pm (starting 22 April)
• Writing as Therapy - Tuesdays 6.30-7.30pm (starting 23 April)
• Self-Esteem Group - Wednesdays 5.00-6.00pm (starting 8 May)
• Stress Management Group - Thursdays 4.00-5.00pm (starting 2 May)
• Get to grips with your Study Strategy – Wednesdays 12.30-1.30pm (starting 24 April)

Individual counselling

Availability

Enter times you are available. Appointments last for 50 minutes. The first appointment is at 9am, the last starts at 7pm. We also offer appointments at Langford on Wednesday afternoons.

• Monday
• Tuesday
• Wednesday
• Thursday
• Friday
• Langford

Counsellor preference

Does it matter if you see a male or female counsellor? Yes No

If so, please state: Male Female

Form submission