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19 – 21 Queen Charlotte Street / 0131 563 6243

Self Referral Form

Thank you, the form has been sent.

One of out team will be in touch with you very soon. Please feel to get in touch at any time.

Let us know what you’re experiencing or hope to work through. We’ll help connect you with a therapist who fits your needs.(required)

Full Name

Phone Number

Email Address(required)

Therapist Preference – Choose one option(required)

Female Male Either

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All enquiries are strictly confidential and safely stored by Edinburgh Therapy Centre. We will never share your details or use them for marketing.

Edinburgh Therapy Centre 19 – 21 Queen Charlotte Street / 0131 563 6243 mail@edinburghtherapycentre.com