New Client Information – ICF Consultations & Psychotherapy

PSYCHOTHERAPY

Our practice utilises evidence-based systemic, relational, psychodynamic and cognitive-behavioural therapy approaches and interventions depending on the presenting difficulties and what fits best for you. We see people from across the life-span and have experience offering compassionate psychotherapeutic support for a wide range of mental health, physical health and relational difficulties.

Individual psychotherapy

Couple therapy

Family Psychotherapy

Group Therapy

Gender Exploratory Therapy (GET)

Family Therapy for Eating Disorders (FT-ED)
OTHER SERVICES

We offer clinical supervision and consultation and develop training programs for both individuals and groups / organisations. Our associates are approved supervisors and trainers by the Association for Family Therapy & Systemic Practice and also part of the UK Council for Psychotherapy’s approved supervisors register.

Supervision

Consultation
TRAININGS & CONFERENCES

ABOUT

Here you can find additional information about the ICF Consultations service and the team of psychologists and psychotherapists.

ICF Consultations

Anastassis Spiliadis

ICF Team
CONTACT

New Client(s) Information Form

DATE

Please include all names of the people who might attend at least one of the sessions at some point. If there are any other names people are known as, please include these in brackets next to the legal names.

Name:

DOB:

Name:

DOB:

Name:

DOB:

Name:

DOB:

Name:

DOB:

Address:

Telephone No:

Telephone No:(2)

Email

Emergency contact Name and Telephone No:

Problem / challenge you would like help with:

GP / family doctor’s Details:

Permission to copy in GP / family doctor:

YES NO

Other professionals involved:

How did you find my details:

Self-Funded:

YES NO

If insurance funded, please give full details:

* As part of the relationship between the practice and the patient(s) / client(s), we might be required to send reports and other documents containing sensitive information. Our policy is to send these password-protected with the patient’s / client's date of birth (in the form of DDMMYYY) via email unless instructed otherwise by the patient / client. Please tick the box below to confirm that you understand this and have read our privacy statement in our T&C document sent to you.