Congratulations on taking the first step to getting the support you deserve, quality accessible counselling through iCounselling. To get started we need to ask you a few important questions and check your immediate well being. This process takes about 5 minutes including collecting your payment. All details collected from you are done so in accordance with our Privacy PolicyDo you have any active thoughts of ending your life, harming your self or harming someone else?* Yes No You have indicated you may be at risk of immediate harm You've told us you may be at risk of harm to yourself or others. You may require immediate support. Please call Lifeline on 13 11 14 now if you need to talk to someone immediately. Lifeline is a 24 hour a day service where you can talk to a trained crisis supporter. If life is in immediate danger please emergency Services on 000 now. For more supports accessible immediate please visit our Emergency Support page.Email Address*Please enter an email address to use for your account. All correspondence for your account will be sent to this email address. Your email address is also used to log in to your account. Enter Email Confirm Email Password*Please select a secure password for your account. Password strength must be Good or Strong to enable account creation. Enter Password Confirm Password Strength indicator Full Name* First Last Residential Address*Please enter your current residential. If you have a postal address you'll be able to enter it below. To provide this service we do require your residential address. 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Postal AddressIf you have a postal address please enter it below. This section is optional. If you do not have a postal address please leave it blank. Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Date of Birth*Please enter your date of birth. Format for your date of birth is DD/MM/YYYY DD slash MM slash YYYY Phone Number*We require a valid phone number in case we need to contact you in a emergency. Please use a mobile phone number where possible.All services provided by iCounselling are bound by various terms, policies and client agreements. We encourage you to review these before continuing. Your continued access of this site and services signifies your agreement to these. You can at any time access these policies via our Terms, Policies, Agreements link at the bottom of every page on our website.Agreement to Terms, Policies, Agreements* I acknowledge I have read in full and understood the Client Confidentiality Agreement, Fair Use Policy, Privacy Policy, Social Media Policy and Terms and Conditions. You have indicated you are under the age of 18 years old We can't provide services to anyone under the age of 18 years old. Please call Lifeline on 13 11 14 now if you need to talk to someone immediately. Lifeline is a 24 hour a day service where you can talk to a trained crisis supporter. If life is in immediate danger please emergency Services on 000 now. For more supports accessible for anyone under the age of 18 please visit our under 18 year old support page. We are unable to create a account and provide you with a service while you are under the age of 18. Please consider our service at another time in the future.You have indicated you may be at risk of immediate harm You've told us you may be at risk of harm to yourself or others. You may require immediate support. Please call Lifeline on 13 11 14 now if you need to talk to someone immediately. Lifeline is a 24 hour a day service where you can talk to a trained crisis supporter. If life is in immediate danger please emergency Services on 000 now. For more supports accessible immediate please visit our Emergency Support page. We are unable to create a account and provide you with a service while you are at immediate risk. Please consider our service at another time in the future.
