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Eligibility Form for Funded Therapy Sessions

We provide fully funded therapy sessions for individuals who may not be able to afford private therapy. Please complete this form and upload the required documents to determine your eligibility. All information provided will be kept strictly confidential.

1. Personal Information


2. Address Information:


3. Financial Information:


4. Referral Information:


5. Required Document Uploads:

Drop your file here or click here to upload
Drop your file here or click here to upload
Drop your file here or click here to upload

6. Additional Information:


Note: If you do not receive benefits but feel you may still be entitled to our services, please email us at support@mhwfoundation.co.uk for further assistance.
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