Rebecca Helps Counselling
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Home
Leader Within Self Development
Counselling
Individual
Family
Children/Teens
>
Children
Teens
Group
Bio
Rates
FAQ
Working Together
Mission & Values
Contact
Privacy Policy
Blog
Covid-19
Covid-19 Individual
Covid-19 Group
Covid-19 Contact
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YOUR CART
Interested in the Covid-19 individual sessions (40 mins) for $25 or the Covid-19 Support Group please fill out this form.
Covid-19 Sessions and Support Groups
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Name
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First
Last
Email
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Phone Number
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My phone number is a :
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Mobile (Cell)
Landline
I am interested in:
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Individual Sessions (40 mins)
Support Group (90 mins)
Both
Other
If interested in Group Sessions please indicate which time of day you prefer:
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Mornings
Afternoons
Evenings
Anytime
Comment
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Is it ok for me to contact you via phone and leave a message at the number provided?
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Yes, you can call me and leave a message (voice or text)
Yes, you can call me but don't leave a message
No, do not contact me by phone.
Do you prefer phone call, text or email?
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Phone call
Text
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