Damian Sweeney Online Counselling in Northern Ireland

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SECURITY OF INFORMATION ON THE ACCESS FORM IS GUARANTEED THROUGH SECURE SSL AND HUSHMAIL SERVICES


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1) Contact me through the email link on the home page. Or fill in the questionnaire below for your FREE consultation and FREE first session for 20 minutes. For inquiries call me on my mobile 07990981713 or Whats app number +447990981713 . Referral agents can fill in the access form for clients stating their contact details in the motivation for counselling box.

2) If you have not filled in an access form I will ask you to fill out the form below and send it to me.

3) After our initial FREE consultation we will see if online counselling is suitable for you and which service would be best. Zoom/Vsee/Skype/Google hangouts video. Or Skype/GH/Vsee/ Whats App chat. Alternatively through email or face to face counselling.

4) We will clarify the process, possible length of time involved and talk about our first FREE session before moving forward .

5) If you decide to proceed I will send you the standard online counselling agreement.

6) You can then contact me using Zoom/Vsee/Skype/ Google Hangouts/ Whats App for your first FREE session . If face to face is more appropriate we can arrange to meet in person at an agreed location and you can book and pay for your first session using the paypal button on the website. After which we can discuss further sessions if you wish.


How to get started. hushmaillogo2


NEW CLIENT ACCESS FORM

This Questionnaire will help me assess if online counselling would best suit your care needs and concerns. It is totally private and sent through secure Hushmail. You will not be commited to going forward after giving this information and it will not be shared with any other third parties. If you decide not to go forward all information will be deleted. I will contact you directly after receiving your information through email.

Your Name :
Date of Birth :
Gender :
Your email address :
Employment Status :

Briefly outline your concerns and motivation for seeking counselling. Eg Personal development, achieving your potential dreams and desires, mental health and or substance misuse...

Tick if you have ever gone to online counselling or face to face counselling before.
Online? Face to Face?
Are you currently in counselling or seeing a pychiatrist?
Counselling? Psychiatrist?

What are your current symptoms, anxiety depression etc?

Severity of symptoms :

Are you currently taking any substances eg alcohol or drugs?
If yes, What type?


For your main drug only, frequency of use?
How much do you take?


How would you describe your use?

Please list any medications you are on


Are you currently suicidal or engaging in any self harm?

How experienced are you using Skype/ Vsee or webcam services?

How experienced are you using hushmail or email services?

What type of internet connection do you have?

Are you able to use your computer or mobile device in a private area?


Before submitting your form please read our Privacy Notice.
I have read and accept the GDPR privacy notice


Please submit this Questionnaire by clicking ‘SEND’



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