Make an Appointment – Care to Care Programme

Subsidised self-care counselling (up to 5 sessions) for frontline helping professionals from NCSS member organisations and MOH public healthcare who work directly with clients/patients.

To provide a safe space for you to address your difficulties such as compassion fatigue, burnout, work-related trauma and/or personal issues.

All information collected through this form will be treated as confidential.

Our Client Services team will contact you within 3 working days to discuss your counselling request.
For verification purpose, please provide a copy of your professional name card and your latest payslip/CPF Statement to us before your first appointment.

Client's Particulars
Name*
Gender*
Local Contact Number*
Email*
Job Designation*
Total gross monthly income (inclusive of all freelance/part-time/contractual employment)*
Date of commencement with current agency
DD slash MM slash YYYY
Name of Organisation*
Date of Birth*
DD slash MM slash YYYY
Marital Status*
Please briefly describe the challenge that you are seeking professional counselling for.
Declaration*
- By submitting my personal data here, I hereby agree and consent that Eagles Mediation & Counselling Centre (EMCC) may collect, store and process my personal data that I have provided for the purpose of administration.
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For Approval
Phone
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Make an Appointment – Care to Care Programme

Client's Particulars

For Processing

For Approval