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Begin Email Counselling

Thank you for deciding to take the step to connect with a counsellor; we recognise that asking for help can be a scary thing to do.

Please note that this is a service for men who have experienced sexual abuse or assault and their partners, friends and supporters. If you require counselling for any other issues, please access Spiritus Online Counselling Services instead.

Intake Form

You can send your first email to your counsellor by using the intake form below. Answering these questions will enable your counsellor to get to know you a bit and learn about your situation and history, and/or your goals for counselling. Please add as much or as little information as you are comfortable with.

The contents of this form will be sent directly to a counsellor. The counsellor will then reply to you, within two working days, to introduce themselves and begin working with you.

Your Name

What email address should your counsellor reply to?*

What would you like to talk about in counselling?

Is there anything else you'd like your counsellor to know?

Please select a password to protect your email messages

Please check this box to indicate that you have read and agree to the Online Counselling Service Agreement and the Privacy Statement*
I agree

Submit

* Required

A resource for men who have experienced child hood sexual abuse or sexual asssault and for their supporters

Begin Email Counselling

Intake Form