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 Intake Officer 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.
CAPTCHA
Hidden
For Processing
Hidden
For Approval
Comments
This field is for validation purposes and should be left unchanged.

Subscribe to our Newsletter

Make an Appointment – Care to Care Programme

Client's Particulars

For Processing

For Approval

Subscribe to our Newsletter