• Getting Started with Verus Minds

  • Thank you for reaching out to Verus Minds. Taking this first step is often the hardest part, and we're glad you're here.

    Please complete this form as fully as you feel able to. It helps us understand what you're going through and consider whether our service is the right fit for you. There are no wrong answers, and you can share as much or as little as feels comfortable. 

    We offer CBT online across the UK and in person in London. One of our founding therapists will personally review your form and be in touch within 2–3 working days.

    Submitting this form is the first step in our process, and while it doesn't guarantee an appointment, it helps us make sure we can offer you the right support. 

    Once we receive your referral, the founders will review the information you have provided. If we are able to offer you the right support, we will contact you to confirm this and arrange a brief call, during which you can ask any initial questions. You will then receive information about booking your assessment and our welcome pack.

    Please note that Verus Minds is not a crisis or emergency service, and referral forms are not monitored continuously. If you need urgent mental health support, contact NHS 111 and select the mental health option. If there is an immediate risk to your safety or someone else’s, call 999 or attend your nearest A&E.

  • 1. About You

  • Date of Birth*
     - -
    2 digit day, 2 digit month, 4 digit year

  • Verus Minds Psychological Services Ltd  |  Registered in England & Wales | verusminds.co.uk

    For queries about this form contact us at info@verusminds.co.uk  Version 1.0 – 2026.

  • 2: What brings you to therapy?

  • 2. How long have these difficulties been affecting you?*
  • 0/500

  • Verus Minds Psychological Services Ltd  |  Registered in England & Wales | verusminds.co.uk

    For queries about this form contact us at info@verusminds.co.uk  Version 1.0 – 2026.

  • 3: Brief Risk & Safety Screening

    These questions help us ensure the service is safe and appropriate. Answering “yes” does not automatically exclude you from support.

  • Important: Verus Minds Psychological Services is not a crisis or emergency service. If you need urgent support, please contact your GP, NHS 111, or emergency services.

  • 7. Over the past month, have you had thoughts about harming yourself or ending your life?*
  • 9. Do you currently feel able to keep yourself safe?*

  • Verus Minds Psychological Services Ltd  |  Registered in England & Wales | verusminds.co.uk

    For queries about this form contact us at info@verusminds.co.uk  Version 1.0 – 2026.

  • 4: Motivation & Readiness for CBT

  • 0/500
  • 12. CBT is an active, structured approach that may involve trying strategies between sessions. How ready do you feel to engage with this type of work?*

  • 5: Practical Preferences

  • 13. Therapy preference
  • 0/200
  • 15. Please provide your GP information for clinical safety and emergency contact only.*

  • Verus Minds Psychological Services Ltd  |  Registered in England & Wales | verusminds.co.uk

    For queries about this form contact us at info@verusminds.co.uk  Version 1.0 – 2026.

  • 6: Consent & Next Steps

    Please read each statement carefully before submitting this form.

  • The information I have provided is accurate to the best of my knowledge.


    I understand that submitting this form does not guarantee an appointment.

    (My referral will be reviewed and I will be contacted within 2–3 working days.)


    I understand that if there is an immediate risk to my life or someone else’s life, Verus Minds may contact my GP or emergency services without my prior consent.

    (In all other circumstances, we will discuss any third-party contact with you first.)

     

    I understand that Verus Minds is not a crisis or emergency service and that I will seek urgent help elsewhere if needed.

     

    I have read and understood the privacy and data protection policy https://www.verusminds.co.uk/service-policies

  • *

  • Verus Minds Psychological Services Ltd  |  Registered in England & Wales | verusminds.co.uk

    For queries about this form contact us at info@verusminds.co.uk  Version 1.0 – 2026.

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