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EATING DISORDERS SUPPORT SERVICE SCOTLAND

Scotland's Leading Private Service for Eating Disorders

Looking to make a referral? Want to book an appointment on behalf of someone else? Complete the quick and easy Referral Booking Form below. Thank you!

If you are an third party individual or an organisation referring an individual for one-to-one help and support, please complete both the Referrer Details and Client Detail Sections below to make an appointment. Please seek permission from the individual you are referring before getting in touch.


If you are making an appointment for yourself, please complete the  Appointment Booking Form here. We will respond within 2-3 working days (excluding weekends). Please check your spam folder or re-sent your email if you do not receive a reply within 2-3 working days.

Appointment Booking Form

Please ensure you complete all sections marked * as the form will not send if these sections are not completed. A message will appear below when your form has been sent to us successfully.  We will ALWAYS reply to your email, so if you don't get a reply within 2-3 working days, please check your spam folder or re-send your email. Thank you.

SECTION 1: REFERRER'S DETAILS

 
 
 
 
 
 
 
 
 
 
 
We will fund open-ended treatment (no specific number of appointments allocated)
The client and therapist will decide this
We will fund a specific number of appointments (please specify below**)
This is negotiable and we will discuss this with Talking EDs
Other (please specify below**)
 
Client (self-funding)
Another individual (please specify in the box below **)
Referring Organisation/Company (please specify below **)
Other (please specify below **)
 
 
Client
Referring Organisation/Company
Relative Friend
Other (**please specify below)
 
 
Client Only
Referring Organisation/Company
Both Client and Organisation/Company
Other (please specify below**)
 
 
Yes
 
 
 
 
 
 
 
 
 
 
 
Yes
No
 
 
Yes
No
 
Yes
No
Awaiting Treatment
 
 
Yes
No
 
 
 
 
 
 
CBT (Cognitive Behavioural Psychotherapy)
Integrative Psychotherapy
CBT-T ED (10- session CBT programme for non-underweight eating disorders)
General/Humanistic/Person-Centred Counselling
Clinical Hypnotherapy
Solution Focused Brief Therapy
Guided CBT Self-Help (with a therapist)
Stress Management Therapy/Coaching
Life/Personal Coaching
Rewind Trauma Therapy Technique (3 session programme)
Grief and Bereavement Therapy and Counselling
Trauma Therapy
Couples Counselling and Relationship Therapy
Online Therapy and Counselling
Group Therapy (only available if we have 5-6 people attending every 2 weeks)
Dietitian and Nutrition Services (this is only available if you are also working with a therapist here or elsewhere).
Carers and Supporters Therapy and Counselling
Any approach is suitable
Not Sure
Other (please specify below**)
 
 
Morning
Afternoon
Evening
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Any Day/Time
Other (please specify below**)
 
 
Alexandra (Lead/Senior Accredited Psychotherapist and Clinical Director)
Amanda (Advanced Therapist and Counsellor)
Jackie (Therapist and Counsellor)
Jenny (Dietitian) (dietetic and nutrition services are only available alongside seeing a therapist here or elsewhere)
Liz (Advanced and Accredited Therapist and Counsellor)
Natalia (Therapist/Counsellor and Coach)
Sue (Therapist and Counsellor)
I have no therapist preference and can work with any therapist
CBT-T, Rewind Trauma Therapy, Coaching, Couples Therapy and Single Session Therapy - please see Price List for fees for these therapies
 
Face-to-face/In-Person
Online
I am happy to access either face-to-face or online appointments
 
Yes
No
Maybe (please specify below**)
 
 
 
 
Yes
No
 
Search Engine (e.g. Google, Yahoo etc.)
Word-of-Mouth
Beat Listing
Other professional (e.g. GP, therapist etc.)
Family/Friend
Workplace
Counselling Directory
Recommendation
Social Media (e.g. Facebook, Blogger, Twitter, Linkedin etc.)
Other (please specify below**)
 
 
Email
Text
Both
 
Yes
 
Email
Text
Both
Other (please specify**)
 
 
 
 

SECTION 2: CLIENT DETAILS

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Trading as M.H.Well. Copyright© 2010,2021. All Rights Reserved.

Address:

Talking EDs (Eating Disorders Support Service Scotland), Glasgow Therapy Rooms, Fitzgerald Room, Isherwood & Orwell Rooms, Regent Business Space, 2nd Floor, Left Wing, 180 West Regent Street, Glasgow, G2 4RW

 

support@eatingdisorderscotland.co.uk

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