Create an account

To create a Therapy For You account you must either be 18+ and live in South East Essex or be registered with a South East Essex GP. For those living in or registered in North East Essex, the service is available to those who are 16+. For both areas you must not be seeing any secondary care mental health services or under the care of a crisis team.

Watch the video above for more information

Have a question about filling out this form?

You can find all of our contact details here. Send us a message or call us between 9am and 5pm Mon-Fri to speak to a member of staff.

Personal Information

Title

First Name

Last Name

Date Of Birth

Gender

Sexual Orientation

Address

Town

County

Postcode

Account Information

Due to the confidential nature of this site, we require all users to provide a valid mobile number. We will send important information via text message.

Telephone

Mobile

Confirm Mobile

Email^* This will be your username

Confirm Email^* Please confirm email

Password^* Minimum of 8 characters

Confirm Password^* Please confirm password

Security Question

Security Answer

Ethnicity & Religion

Ethnic Origin

Religion

Employment & Education

Current Education Status

Employment Status

Currently unable to work due to medical reasons

Statutory Sick Pay

Receiving Benefits

Jobseekers Allowance

Employment and Support Allowance

Universal Credit

Personal Independence Payment

Other Benefits

Do you feel that you would benefit from support to help gain or maintain employment?

Consent

In order to gain access to treatment you must give Therapy For You consent to send you email and text messages that directly relate to your treatment. The permissions below relate to communications outside of the essential email and text messages sent by the site. Your details will never be used for marketing purposes or sold to third-party agencies.

Receive Email Alerts?

Receive Text Alerts?

Voicemails

By creating an account you give your consent to treatment and confirm you have read and accepted the privacy policy of this website

Crisis
link