Thank you for your enquiry regarding a referral for Psychosynthesis counselling. All of our counsellors are qualified, professional and experienced members of BACP and/or UKCP. They practice in varying locations across London. Sessions in the low-cost-clinic are held at our premises in Tooley Street. Counsellors are referred by the Counselling Service Manager and matched to meet the specific needs of each client.

After completing the form, please ensure all mandatory fields are entered and terms & conditions checked.
After clicking 'send your application ' you will be redirected automatically to make payment of the registration fee. Please note that you can make payment via PayPal whether or not you have a PayPal account. If you do not have a PayPal account, when redirected, please click ‘Pay by Debit or Credit Card’.
Should this not be the case, please contact us via email

You will be referred to a counsellor as soon as possible. This process should not take long but please bear in mind that we will need to contact the therapist to confirm availability and more importantly suitability for your current needs.

Fields marked with an * are required

Counselling and Psychotherapy Service Questionnaire

(as it appears on your passport)

*The more flexible you can be the easier it will be to find the right therapist for you.

Terms and payment

There is a £25 registration fee for this service. The cost of a weekly session is agreed upon with the assigned therapist. Fees are in the region of £50-£70. This depends on a number of factors including location, times and the individual therapist. To assist us with your placement, please complete the questionnaire. After having submitted the form, you will be led to Paypal, please make payment of the registration fee.


Problems submitting the form?

Click below to download a copy of this form.

When you have completed the offline form, please email all required documents to

Click here to go back to the counselling page