Therapy application form

Before you submit this form, please call our Advice Line on 0800 707 6607 for a confidential chat with one of our six friendly and experienced Senior Support Advisors. This is so we can offer initial support, be sure that the therapies are appropriate for your needs and share details of any other services which you may find useful.

As part of our Resilience Programme, NABS can provide access to a range of short-term therapies which offer support for managing a range of challenges. These can include low self-esteem, anxiety, depression, difficulty sleeping, grief, eating problems, obsessive-compulsive disorder, trauma, post-traumatic stress disorder and personality disorders, amongst others.

NABS is partnered with an independent therapy provider. One of their therapists will do an initial assessment and recommend the most appropriate type of therapy for your needs. NABS can cover the cost of seven to twelve sessions of therapy, depending on the type of therapy required. Anything discussed during therapy will be treated confidentially by the therapist.

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Name *

Name value is required

Gender *

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Telephone number *

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Email address *

Email address value is required

Date of birth *

Date of birth value is required

Company *

Company value is required

Role *

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Please briefly explain the ways in which you anticipate therapy will help you *

Please briefly explain the ways in which you anticipate therapy will help you value is required

If you are currently having therapy, is your therapist aware and supportive of you accessing therapy through NABS?

If you are currently having therapy, is your therapist aware and supportive of you accessing therapy through NABS? value is required

Confidentiality: all information that you provide to NABS will be handled confidentially under the terms of the Data Protection Act 2018. The details disclosed on this form will only be shared with NABS’ external therapy partner. They will not be disclosed to other parties without your permission.