Contact

About You

First & Last Name (required)

Email Address (required)

Phone Number (required)

Pronouns (e.g. she/her, they/them)

Preferred Language for Sessions *

English

Español

Country of Residence (required)

Session Preferences

Are you 18 years of age or older? *

Yes

Do you have access to a safe, private, and uninterrupted space for online video sessions? *

Yes

Unsure

This form books your free 15-minute consultation — there's no charge to reach out. Let us know which service you're interested in below; the price shown is for ongoing sessions once we begin working together.

Which service are you interested in? *

Individual Therapy (€50 / session)

Life Coaching (€65 / session)

Couples Therapy (€75 / session)

Briefly describe what brings you to therapy at this time. (required)

Final Details & Consent

How did you hear about Therapy Unplugged?

Google Search

Social Media

Referral

Other

I understand this form is for scheduling only, is not monitored for emergencies, and I consent to my data being processed per the site's Privacy Policy. If in distress, I will contact 999/112, go to A&E, or text HELLO to 50808.

Get in Touch

Send an Inquiry

About You

Session Preferences

Final Details & Consent

Connect Directly