We fight to improve the lives
of everyone affected by epilepsy

Epilepsy Action Northern Ireland counselling enquiry form

The information you provide will only be used for the purpose of accessing the counselling service.

We will not keep this information after you have accessed the service. We will only use your contact details if you complete the ‘keep in touch’ section at the back of the form.

Criteria for accessing the counselling service

  • You are over 18 years of age
  • You consent to engage with online or telephone counselling services
  • You have a diagnosis of epilepsy, or you are caring for someone with a diagnosis of epilepsy
  • You live in Northern Ireland
  • We cannot provide counselling to anyone currently under the care of mental health services
Your details
Your address
The service is for people aged 18 and over.

 

 

Please make sure you have given us the relevant contact information e.g. if you have selected email, please provide an email address in your contact details.
Please make sure you have given us the relevant contact information e.g. if you have selected email, please provide an email address in your contact details.

 

Epilepsy Action will never swap, share or sell your details. For more information, read our privacy policy.

You can update your preferences at any time by contacting our supporter care team on 0113 210 8800 or using our online form.