Client Registration

Please complete our Client Registration form if you want to enquire about registering for our services

To contact Arkordia for any other reason, please complete our General Enquires form

Client

Your Name *

Please provide your full name

Your Email *

Please provide your personal e-mail address for us to contact you

Phone *

Please provide your mobile or another phone number for us to contact you

Please indicate if you are happy for us to leave a voicemail *

Yes

No

Address *

Please provide your address. We are currently only able to take on clients from Edinburgh and The Lothians area.

Postcode *

Please enter your Postcode

Service you are interested in * Individual TherapyCouple Therapy

Please indicate which of our services you are interested in

Additional Information

Please enter any additional information here

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