Thank you for completing this form. We understand that the first step is always the hardest.
UPside counsellor's a here to listen to your story and come alongside you on your unique journey. 
Please complete this form as accurately as possible so that we can best assist you.

While UPside will provide counselling to people younger than 18 we will require consent from a parent or gaurdian to continue.

In order to help us help you best it would be helpful if you could briefly describe here why you are requesting counselling.