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appointment request

Healing Hearts with Mary

Bringing Clarity, Hope and Healing We provide non-clinical psychosocial and emotional wellbeing support to individuals experiencing emotional difficulties, relationship challenges, loneliness, uncertainty and other life struggles. Our goal is to help you gain clarity, recognise your strengths and explore practical steps towards improved emotional wellbeing. Please complete this form to request an appointment. Your preferred appointment date and time will be reviewed, and confirmation will be sent to you.

Client Appointment Request Form

Please complete this form to request an appointment.

5. Preferred LanguageRequired
6. What would you like support with?

You may select more than one.

Please share only what you feel comfortable sharing. You do not need to provide detailed medical or personal records.

9. Preferred consultation method
12. Preferred days

I understand that Healing Hearts with Mary provides non-clinical psychosocial and emotional wellbeing support, does not replace professional medical care, psychiatric treatment or psychotherapy, that submitting this form is an appointment request and does not automatically confirm a booking, and I consent to being contacted about my appointment request.

I understand that the information I provide will be used to respond to my enquiry and manage my appointment. I consent to its use for these purposes.

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