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Mandatory fields are marked with a red asterisk (*).
If you have any problem completing the form please email us or call and leave your details on our answerphone (01273 911680)
Please note: Due to the level of demand for our services, the current total waiting time is around 8 months (around 2-3 months for an initial meeting, then another 4-5 months for counselling to start).
If you are in crisis and looking for immediate assistance, please phone the National Male Survivors Helpline on 0808 800 5005.
If you do NOT live in Sussex, find out about services available in your area via the Male Survivors Partnership
We require clients to refer themselves to us personally – we do not accept third-party referrals. If you are attempting to refer someone else to us, please email us first, including their consent for you to contact us and explaining clearly why they are not able to fill in the form themselves.