How to contact Aubrieta Online Therapy:

Email:
vicki@aubrieta-online-therapy.com

or alternatively, you can fill out the self referral form below. Please note our self referral form is not monitored for urgent support.

There's no obligation to book. Getting in touch is simply a way to explore whether this support might be right for you and I aim to respond to emails within 48 hours.

Aubrieta Online Therapy Self Referral Form
Please complete this form to find out if our service could be a helpful match for you.

Name*

This field is required.

Date of Birth*

This field is required.

Email*

This field is required.

I am 18 years old or over, I live in the UK and am not receiving therapy from another mental health or psychological therapy service.*

This field is required.

Please summarise the mental health difficulties that you currently experience.

I am aware that I should contact my GP in the first instance if I believe I am concerned about harming myself or others. *

This field is required.

Please summarise any previous therapy you have attended.

Please use this space to let me know your availability for an initial online meeting and for any additional information or queries you wish to add.

I hereby agree that this data will be stored and processed for the purpose of establishing contact. I am aware that I can revoke my consent at any time.*

* Please fill in all the required fields.

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Your referral has been submitted successfully. We'll be in touch shortly.

Thank you for visiting Aubrieta Online Therapy

How to contact Aubrieta Online Therapy:

Aubrieta Online Therapy Self Referral FormPlease complete this form to find out if our service could be a helpful match for you.

Aubrieta Online Therapy Self Referral Form
Please complete this form to find out if our service could be a helpful match for you.