Initial Enquiry

This short form helps us understand what you’re looking for and guide you to the right next step.

"*" indicates required fields

Step 1 of 5

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This field is for validation purposes and should be left unchanged.

Let’s get started

This short form helps us understand what you’re looking for and guide you to the right next step.

Most families don’t need a call at this stage — once we have a little information, we can usually recommend next steps straight away.

1) Your details

Your Name*

First Last

Email*

Phone*

2) What are you looking for?

I am looking for*

Please select the option that best reflects your needs

Therapy for my child / young person

Therapy for me

Parent consultation or guidance

3) Child/young person's details

Child or young person's name

First Last

Child or young person's age*

What are your main concerns at the moment?

Select up to 8 choices.

Worries, fears or anxiety

Low mood

OCD

Tics or Tourette Syndrome

Behavioural or emotional difficulties

Body image issues

Eating issues *

Self harm

Neurodevelopmental

School-related difficulties

Trauma

Attachment or parent-child relationship concerns

Sibling rivalry or issues within family

Low self-esteem

Post-adoption support

Challenging Behaviours

Learning disabilities

Parenting support / consultation

Something else

* we do not treat active eating disorders but will see young people on their recovery journey once specialist services have completed their interventions, we see young people with ARFID and fussy eating.

Please give details

4) Practical considerations

Where would you like support to take place?*

At our practice in Marylebone, London

Online

Home Visit

I don't mind

Our current fees are £200-250 per session (clinician dependant). Does this feel manageable for you?*

Yes

Possibly, I’d like more information

We work with the following UK insurers, please tick any applicable to you.

WPA

BUPA international

Cigna UK

Cigna International

4) How would you like to proceed?

What would feel most helpful next?*

I’d like to complete a full intake form so you can recommend next steps

I'd like the practice administrator to call me

I’m not sure – please advise

Additional comments

Mailing list

Tick here to occasionally receive information about our therapy groups, workshops and trainings.

Consent to contact and PR*

I confirm that I have parental responsibility and consent to CY&A Psychology contacting me about this enquiry*

I have read and agree to the privacy policy*

We read every enquiry carefully. If we think a call would be helpful, we’ll suggest one — even if you haven’t requested it.

Faith-Sauders

Hi there, I’m Faith and I’m here if you have any questions or would like to discuss anything.

Make an Enquiry WhatsApp

If you have a question, you can also check out our frequently asked questions.

Please fill out the form below and we’ll get back to you. Alternatively, you can call us on 020 7458 4570 or send us a WhatsApp.

Don’t forget to check our frequently asked questions.

"*" indicates required fields

Step 1 of 2

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Your Name*

Child's Name*

Your Email*

Your Phone Number

Preferred Contact Method

Phone

Where are you based?

International

Are you filling this on behalf of someone else?

Yes

What is their age?*

Please enter a number from 0 to 24.

Are you using medical insurance

Yes

Which insurance company?*

What are you seeking help for?

Stress

Anxiety

Depression

Trauma

OCD

BDD

Relationships

Psychosis

Not sure

Additional Comments

Name of referrer

How did you hear about CY&A Psychology?

Have you had previous treatment for this problem?

Yes

If your teen would like to build and strengthen their social skills and friendships then register for our PEERS® group (call or email us). It starts on 8th September 2026 at 7pm (PEERS® is UCLA’s Program for the Education and Enrichment of Relational Skills)

Make An Enquiry