Welcome to Tung Ling Counselling!
Tung Ling Counselling Centre (TLCC) seeks to to empower every person in our community in their journey of healing and restoration, through goal-oriented counselling and mental health and wellness educationTLCC is part of Tung Ling Community Services (TLCS), which is the community services arm of Church of Singapore (COS).
Please access our new registration form through this link:
https://tunglingcounsellingcentre.my.salesforce-sites.com/CounsellingRegistrationForm
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Name
First Name
Last Name
Email 电邮
example@example.com
Contact Number 联系号码
*
e.g. 98765432
Age Group
*
18 years old and under
19 to 25 years old
26 to 35 years old
36 to 50 years old
51 to 60 years old
61 to 70 years old
Above 70 years old
Gender
*
Female
Male
Marital Status 婚姻状况
*
Single 单身
Married 已婚
Divorced 离婚
Widowed 寡妇 /鳏夫
Occupation
*
Race 种族 (optional)
Indian 印
Malay 巫
Eurasian 欧亚
Chinese 华
Other
Religion 宗教 (optional)
Buddhism 佛教
Hinduism 兴都教
Islam 伊斯兰教
Roman Catholic 天主教
Christian 基督教
Taoism / Ancestor Worship 道教
Other
I want to talk to the counsellor about 我要跟辅导员讨论关于 (select all that apply)
*
Stress 压力
Grief 丧亲的悲痛
Insomnia 失眠
General Emotional & Mental Health 心理与精神方面
Financial issues 财务
Abuse 虐待
Marital issues 婚姻
Parenting 亲子
Other family-related matters 其他家庭关系的问题
Other relationship issues 其他关系的问题
Schizophenia 精神分裂症
Addiction 成瘾
Anxiety 焦虑
Depression 忧郁
Other types of Mental Disorder 任何形式的心理病状
Other 其他
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Please provide a brief and accurate description of the concern(s) or issue(s) for counselling 请说明情况
*
Are you thinking of ending your life or hurting yourself or anyone else? 你是否有想过自尽或伤害他人？
*
Yes 有
No 无
Have you seen a counselor, psychologist, psychiatrist or other mental health professionals before? 你可曾见过辅导员，心理学家，心理医生或其他心理病症专业人士？
*
Yes 有
No 无
Details of previous mental health professional 治疗者姓名
Name
Organisation
Would you prefer a male or female counsellor?
*
No preference
Male
Female
Would you prefer to receive counselling in-person or online?
*
No preference
In-person (At 145 Marine Parade Road, during office hours only)
Online (Via Zoom video calls)
What is your preferred language? 首选语言
*
English 英语
Mandarin 华语
Other
Emergency Contact Details
*
Name
Relationship
Contact Number
Reason for seeking help at TLC. How did you hear about TLC? 联络东岭辅导事工的原因
Any other comments or concerns 任何其他信息
Submit
Should be Empty: