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Do you need help with Alcohol Problems?


If you're interested in a Skype therapy session, please fill out this form. You'll receive a personalized assessment of your situation and a plan of how we can help you. You are not committing yourself to anything by filling this in.

An individual reply will be sent to you by one of our therapists, free of charge, as soon as possible (they will also list their qualifications and experience). If the advice sounds useful, then you can decide if you want to book a session.

All your information is completely confidential - we guarantee that none of your details will be shared with anyone. Nor will you receive any further contact from ourselves or anyone else. Your details are NOT added to a mailing list.

Your Name
(or an anonymous username)
E-mail Address
How would you describe your current problems with alcohol?
How does it affect your health, your work, relationships etc?
Which things contribute to
your drinking?
What do you hope to achieve from therapy?
What other aspects of your life would you like to improve?
Are there any questions you would like to ask about online therapy?
 

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