Beginning the Conversation

Form progress 0 / 0 fields • 0%
A quiet writing desk with a notebook and a cup of tea, soft natural light
Online Therapy Clinic
New Enquiry  ·  Individual, Couples & Family Therapy

Beginning the
Conversation

A short, confidential form to help us understand what brings you here, and how we might help
Ari Sotiriou, UK accredited psychotherapist  ·  enquiries@online-therapy-clinic.com Ari Sotiriou provides Psychodynamic Individual and Couples therapy via secure Live Video. Dr Ruxandra Ion provides psychiatric expertise and BABCP-accredited CBT. UK practice  ·  50-minute sessions, on the hour.
🔒
How this form is handled Everything you write here is confidential and will only be read by the clinical team at Online Therapy Clinic. Your answers are saved as a draft in your own browser as you go, so you won’t lose your progress — but nothing reaches us until you press “Send my enquiry.” This form is the start of a conversation, not the start of therapy itself.
Your draft will be saved automatically as you write.

This form should take about ten minutes. Its purpose is simply to help us understand a little about you and what has brought you to reach out now, so that we can tell you whether we are likely to be the right fit before your first session, and prepare properly for it if so.

There are no wrong answers, and you do not need to explain anything fully. A sentence or two is enough anywhere you see a longer question. Anything marked with an asterisk (*) is required — everything else is optional.

✉️
What happens after you send this
  • You’ll receive a short reply, usually within one to two working days.
  • If it looks like a good fit, we’ll offer a free 15-minute introductory call to answer questions before you commit to anything.
  • A fuller assessment takes place in — or just before — the first session itself.
Section 1 Contact Information

We’ll only use this if we can’t reach you by email, or to let you know we’ve replied to your enquiry.

This also helps us work out your time zone — no need to look up a GMT offset.

Section 2 Practical Information

I am seeking… *

Did you read one of our blog articles before contacting us?
Are you able to commit to attending a weekly 50-minute session?
Section 3 Reason for Contact
Section 4 Previous Therapy
Have you had therapy before?
Section 5 Mental Health History

Tick any that feel relevant — past or present. This simply helps us prepare; it does not need to be precise.

Have you ever received a mental health diagnosis? (optional)
Is alcohol or drug use currently part of the difficulty that brings you here?
Section 6 Medication
Are you currently taking medication for your mental health?

We’ll ask about dosage, how long you’ve been taking it, and your prescriber at the assessment stage.

Section 7 A Few Safety Questions

We ask everyone these same questions, regardless of what has brought them to us. They help us make sure online therapy is a safe and appropriate setting for you.

Are you currently experiencing thoughts of harming yourself?
Have you attempted suicide in the past?
Do you currently feel safe?
Is anyone currently at risk because of your situation?
⚠️
Thank you for telling us this honestly Because of what you’ve shared, we may need a short phone conversation before starting online therapy, to make sure we can support you safely — online therapy is not suitable for everyone in every circumstance. This form is not a substitute for immediate help: if you are in danger right now, please contact emergency services or a crisis line in your area.
Section 8 About Both of You

Since you’ve indicated couples therapy, it helps to have a little information about each partner.

Partner A
Partner B
Has either partner already decided the relationship is over?
Section 9 Medical Information
📋
We’ll go through any significant medical conditions and take an emergency contact together at your assessment, once we’ve had a chance to meet — there’s no need to share these details here.
Section 10 Online Therapy Requirements

Online therapy suits most people well, but it does depend on a few practical things. These questions simply help us check the fit.

Can you usually find a private place where you won’t be interrupted for 50 minutes?
Have you previously used video calls comfortably?
Are you currently living in a country where online psychotherapy is legally permitted, to your knowledge?
Section 11 Before We Meet
Section 12 Consent

Fields marked * are required. Your reply will come from enquiries@online-therapy-clinic.com — please check your spam folder if you don’t hear back within a couple of days.

Want a copy for yourself? You can save your answers as a PDF.

A Note on What Comes Next

Once we’ve received your enquiry, we’ll reply to let you know whether we’re likely to be a good fit, and offer a free introductory call if so. There’s no obligation at this stage — it’s simply a chance for both of us to ask questions before deciding whether to go ahead.

If you’d rather speak to someone before writing all of this down, you’re welcome to book that introductory call directly: book a free 15-minute call.

Online Therapy Clinic Clinical Team enquiries@online-therapy-clinic.com  ·  online-therapy-clinic.com  ·  UK practice  ·  50-minute sessions, on the hour
Ari Sotiriou provides Psychodynamic Individual and Couples therapy via secure Live Video. Dr Ruxandra Ion provides psychiatric expertise and BABCP-accredited CBT.