Counselling Service Referral

This is a brief referral form which will be passed on to our counsellor so that they can contact you. Any further information required e.g. Medication history, GP contact details, emergency contact etc., will be discussed directly with you by our counsellor and recorded and filed by them.

Dyspraxia/DCD Ireland does not have access to any confidential information shared between you and your counsellor.

If you or your child are experiencing significant mental health issues this service may not be suitable for you. In such cases we may refer you on to a more appropriate service, with your permission.

Please note

This service is for people 18 years and older.

If you require counselling for under 18s, please contact us at for further information.

Our counselling fees are €20 per session but we do not exclude anyone because they are unable to pay. If you are experiencing financial stress please speak to our counsellor and they will discuss options with you.

Referral Form

Please do not include links in your form submission as they will likely be interpreted as spam by the server.

Fields marked (*) are required

Do you agree that you are willing to work with a Counsellor and Psychotherapist in training (A student counsellor)? All of our student counsellors have primary degrees and strong work experience in a range of professionalisms that complement and enhance their counselling role.

Counselling Service Referral

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