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* 1. Name

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* 2. Phone Number

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* 3. Email address

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* 4. Address / Address of Counselling Offices

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* 5. Name of counsellors / Qualifications (Course and University)

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* 6. Type of counselling

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* 7. Price Range of Services
(e.g. €20-40 per session, €40-€60 per session, €60+ per session)

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* 8. Contact Hours

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* 9. How can people access your services?

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* 10. Is there any of the above information that you would NOT like to be displayed on the website? If you are happy for the above details to be displayed on our website (http://www.havinalaugh.com/getting-support.html), simply leave this field blank.

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