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Oxfordshire Therapy & Self-Development Centres
1-to-1 Counselling & Psychotherapy - Group Therapy & Workshops in Oxford and Witney

OTS Application Form:
For an assessment or referral appointment

This confidential form tells us which of our services you are interested in. You can always email or phone us as an alternative to completing it. If you wish to apply using this form, please complete the personal details section, as well as any questions that are relevant to your area of interest. You can email us if there is anything you are unsure about.

Personal details (*indicates required fields)

*Name:

*Age:
          *Gender:   Male    Female    Neutral
Address:

*Phone:

*Email:

*Occupation:



The OTS Quarterly Newsletter
Our newsletter keeps you updated on our free talks, workshops, groups and items of interest.
You can unsubscribe at any time.

*Would you like to receive our newsletter:   Yes   No


Please choose one or more from the following options, using the text box for option three.

1) I would like a referral interview for 1-1 counselling or psychotherapy,
to find the right therapist for me.   
2) I would like an [assessment] interview to discuss and decide on my best options. i.e. group or individual therapy, and what kind.   
3) I am interested in joining a particular Group/Course/Workshop (please state the title and venue of any event(s) you are interested in).   



Availability

There is high demand for our service, so if an assessment/referral interview is requested/required, please be as flexible and detailed as you can in providing your availability both time wise and geographically for the assessment. This will enable us to have the best chance of offering you an early appointment. We can then refer you to a practitioner in your preferred area, even if you have had an assessment out of your area.

*4a) Are you happy for the initial assessment to be on-line:   Yes   No
*4b) Are you happy for regular sessions to be on-line:   Yes   No
*4c) Your preferred area for face to face sessions:   Witney   Oxford   Either
*5a) I could attend an initial interview in Witney:   Yes   No
*5b) I could attend an initial interview in Combe (OX29):   Yes   No
*5c) I could attend an initial interview in Oxford:   Yes   No
*6) Please give as much detail as you can about your general availability for interview from Monday to Sunday. Please note day time is always easier to arrange a one-off assessment interview:



Low Cost Counselling

7) I require low-cost 1-1 counselling/psychotherapy with trainees in supervision & newly qualified practitioners looking to grow their practice in the fee range £20-£45 per session.   


The following questions are optional, but answering them will help us to ensure you get the most from OTS, whatever your area of interest.

8) Please tell us what you are hoping to gain from the option(s) you identified in the earlier questions.

9) What is your experience of counselling, psychotherapy, self-development and/or any other forms of emotional or psychological work?

10) Please tell us about any special needs you may have which you would like us to take into account when offering you an interview or place in a group or workshop.

Thank you for completing this form.

Once you have submitted your form below you will be be sent an email confirming it has been received, and we will contact you personally shortly afterwards. In the meantime if you have any questions, please email us.

Please note:If the form doesn't send, it means there is a compulsory 'starred' question you still have to answer.

     



OTS Request Form:
For your chosen Oxford practitioner

This confidential form tells us which practitioners you want to see. You can always email or phone us as an alternative to completing it. or if there is anything you are unsure about.

Request details (*indicates required fields)

*Name of the practitioner you are contacting:

*Your Name:

*Age:
          *Gender:   Male    Female    Neutral
Address:

*Phone:

*Email:


Availability for sessions - Please give full details on your availability for counselling/psychotherapy:


I can attend in:   Witney   Oxford   Either

*I can attend sessions on-line:   Yes   No

Please provide any details you would like to regarding your reason for contacting me. (Please note that this confidential form will be received by OTS Admin before being forwarded to me)



The OTS Quarterly Newsletter
Our newsletter keeps you updated on our free talks, workshops, groups and items of interest.
You can unsubscribe at any time.

*Would you like to receive our newsletter:   Yes   No


Thank you for completing this form.

Once you have submitted your form below you will be be sent an email confirming it has been received, and we will contact you personally shortly afterwards. In the meantime if you have any questions, please email us.

Before submitting your form please read our Privacy Notice.

     



OTS Request Form:
For your chosen Witney practitioner

This confidential form tells us which practitioners you want to see. You can always email or phone us as an alternative to completing it, or if there is anything you are unsure about.

Request details (*indicates required fields)

*Name of the practitioner you are contacting:

*Your Name:

*Age:
          *Gender:   Male    Female    Neutral
Address:

*Phone:

*Email:


Availability for sessions - Please give full details on your availability for counselling/psychotherapy:


I can attend in:   Witney   Oxford   Either

*I can attend sessions on-line:   Yes   No

Please provide any details you would like to regarding your reason for contacting me. (Please note that this confidential form will be received by OTS Admin before being forwarded to me)



The OTS Quarterly Newsletter
Our newsletter keeps you updated on our free talks, workshops, groups and items of interest.
You can unsubscribe at any time.

*Would you like to receive our newsletter:   Yes   No


Thank you for completing this form.

Once you have submitted your form below you will be be sent an email confirming it has been received, and we will contact you personally shortly afterwards. In the meantime if you have any questions, please email us.

Before submitting your form please read our Privacy Notice.

     



OTS Application Form:
To Apply For A Group

This confidential form tells us which services you are interested in. You can always email or phone us as an alternative to completing it. If you wish to apply using this form, please complete the personal details section, as well as any questions that are relevant to your area of interest. You can email us if there is anything you are unsure about.

Personal details (*indicates required fields)

*Name:

*Age:
          *Gender:   Male    Female    Neutral
Address:

*Phone:

*Email:

Occupation:




Tell us the title, time, day and venue of any group(s) you are interested in.



The following questions are optional, but answering them will help us to ensure you get the most from OTS, whatever your area of interest.

Tell us what you are hoping to gain from the group.


What is your experience of counselling, psychotherapy, self-development and/or any other forms of emotional or psychological work?


Please tell us about any special needs you may have which you would like us to take into account when offering you an interview or place in a group or workshop.



The OTS Quarterly Newsletter
Our newsletter keeps you updated on our free talks, workshops, groups and items of interest.
You can unsubscribe at any time.

*Would you like to receive our newsletter:   Yes   No



Thank you for completing this form.

Once you have submitted your form below you will be be sent an email confirming it has been received, and we will contact you personally shortly afterwards. In the meantime if you have any questions, please email us.

Before submitting your form please read our Privacy Notice.

     



OTS Application Form:
To attend a public talk or workshop

This confidential form tells us which talk or workshop you are interested in. You can always email or phone us as an alternative to completing it. If you wish to apply using this form (most questions are optional), please complete the personal details section, as well as any questions that are relevant to your area of interest.

Personal details (*indicates required fields)

*Name:

*Age:
          *Gender:   Male    Female    Neutral
*Phone:

*Email:



Talk Details.

Please state the title(s) and venue(s) of any talk(s) or workshop(s) you are interested in, as well the possible day options offered that you can attend:


Please tell us if you would like us to contact you regarding any of our other services:



The following questions are optional, but answering them will help us to ensure you get the most from OTS, whatever your area of interest.

1) Please tell us what you are hoping to gain from the event(s) you are interested in.


2) What is your experience of counselling, psychotherapy, self-development and/or any other forms of emotional or psychological work?


3) Please tell us about any special needs you may have which you would like us to take into account when offering you a place on a talk.



The OTS Quarterly Newsletter
Our newsletter keeps you updated on our free talks, workshops, groups and items of interest.
You can unsubscribe at any time.

*Would you like to receive our newsletter:   Yes   No


Thank you for completing this form.

Once you have submitted your form below you will be be sent an email confirming it has been received, and we will contact you personally shortly afterwards. In the meantime if you have any questions, please email us.

Before submitting your form please read our Privacy Notice.

     



OTS Application Form:
To attend an event or group for practitioners

This confidential form tells us which event you are interested in. You can always email or phone us as an alternative to completing it. If you wish to apply using this form, please complete the personal details section, as well as any questions that are relevant to your area of interest.

Personal details (*indicates required fields)

*Name:

*Phone:

*Email:



Event / Group Details.

Please state the title(s) and venue(s) of any event(s) you are interested in:


Please provide a very brief overview of your experience, modality and training:


Let us know if there is anything specific you are hoping to gain from these event(s).


Let us know if there is anything else you would like for us to respond to you about.


Do you have any special needs which you would like us to take into account for any event.



The OTS Quarterly Newsletter
Our newsletter keeps you updated on our free talks, workshops, groups and items of interest.
You can unsubscribe at any time.

*Would you like to receive our newsletter:   Yes   No


Thank you for completing this form.

Once you have submitted your form below you will be be sent an email confirming it has been received, and we will contact you personally shortly afterwards. In the meantime if you have any questions, please email us.

Before submitting your form please read our Privacy Notice.

     



OTS Room Rental / Centre Membership Interest.

This confidential form tells us what your interest is in using one of our centres. You are welcome to apply to use one of our rooms, apply to join our community or both. You can always email or phone us as an alternative to completing it.

Personal details (*indicates required fields)

*Name:

*Age:

Address:

Current Practice Address(s):

*Phone:

*Email:

Please tell us about your level of experience, training school and orientation


Which of our centres are you interested in? Oxford / Witney / both / neither?


What days / times are you interested in? (Please see websites for room hire details)


When would you be looking to start at the centre?


Are you needing the centre to help you generate clients?


Are you looking to become a member of the OTS Community?


Anything else you would like us to know?



The OTS Quarterly Newsletter
Our newsletter keeps you updated on our free talks, workshops, groups and items of interest.
You can unsubscribe at any time.

*Would you like to receive our newsletter:   Yes   No


Thank you for completing this form.

Once you have submitted your form below you will be be sent an email confirming it has been received, and we will contact you personally shortly afterwards. In the meantime if you have any questions, please email us.

Before submitting your form please read our Privacy Notice.

     



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