Before the paperwork

What should we call you?

Let's begin with the person, not the problem.

How to reach you

Where can we contact you privately?

Use contact details you are comfortable receiving appointment communication on.

Your starting point

What brought you to The Bridge today?

You don't need a clinical label. Choose what feels closest.

In your own words

What has been hardest lately?

There is no right way to answer. A few sentences are enough.

Context for your therapist

Is there anything about your health we should understand?

This may include previous mental-health support, relevant medical history or current medication. Write “None” if there is nothing relevant.

Your safety

Are you experiencing an immediate safety concern?

This includes immediate concern about harm to yourself, harm to someone else, or abuse. The Bridge Therapy is not an emergency service.

Someone we can contact

Your emergency contact.

Please provide someone The Bridge may contact where clinically necessary and consistent with the practice's consent/confidentiality policy.

Consent

Before we cross into care.

By signing and continuing, you acknowledge that counselling involves confidential professional care subject to The Bridge Therapy's consent, privacy, safeguarding and confidentiality terms. The final production version should display the founder-approved legal/clinical consent text here before launch.

✓
Intake prepared

Your side of the bridge is complete.

Your intake is complete. When you’re ready, book your session or reach out if you need more clarity.