General Information

This application form is used to apply for employee assisted programme counselling at Projekt 42.  To complete the form takes less than 5 minutes .

To help you access counselling with the right person, we need to collect some personal information.  Where we collect sensitive information, we do so only to provide the service to you.  Under the Data Protection Act 20128, your permission is needed to collect and keep personal data, whether by manual or electronic means.  By completing and submitting this form, you give us the necessary permission to keep such dat as you are willing to disclose.

Don't worry; if you change your mind, you can exercise your rights under the General Data Protection Regulation May 2018, and you can ask Projekt 42 to delete any information we hold for you.  You can do this anytime by sending an email to data@projekt42.co.uk.  For further information relating to Data Protection, Projekt 42's Privacy Policy, Procedure for Subject Access Requests, email data@projekt42.co.uk.

About Employee

What happens Next

When the referral form has been submitted, you will receive an email to confirm that we have received your form.  If we require any further information, the Projekt 42 Mental Health team will contact you.  Where possible, we will email you; plerase check your inbox and junk forlder for any updates from us.

We aim to work with clients within 4-weeks of receiving your self-referral, and when you receive your first initial appointment, we will provide you with a brief overview of what you can expect from the counselling services at Projekt 42,.

If youn have any questions, please email us at mentalhealth@projekt42.co.uk.