Please use this form to contact us for any advice which you may be seeking. Please state what form of advice you are seeking and be as detailed as possible so we can help you the best we can.
Inspirited Minds are not an emergency service. If however, you require urgent attention, please follow the link here to see the various organisations you can contact.
For any general queries –  please contact us here.

* denotes a required field

Title *

First Name *

Last Name *

Date of Birth *

Gender *

Religion *

City *

Country *

Nationality *

Please state whom you are seeking help for *

Please state what you are seeking help for *
[be as detailed as you can; i.e. what form(s) of illness you suffer from, what sort of help you are seeking, what you current situation is]


Email Address *

Confirm Email Address *

If you are seeking counselling, what form of counselling would you prefer? *

I do not mind if a male/female advisor contacts me

I am aware that my details may be shared with the team and third party advisors. I am aware that, although Inspirited Minds promise to ensure that every case is dealt with in a professional and confidential manner, in special circumstances, (eg: if it is felt that the person who contacted may be in danger or may be under-age), there may be a breach of confidentiality *