Applications – Kenya Institute of Professional Counselling

For enquiries call 0773 339976 , Email: admissions@kipc.co.ke Please fill all the required fields, for a successful registration.

1 APPLICATION FORM

2 CLIENT INTAKE FORM

3 ATTACHMENTS

Rationale for personal therapy (Skip this form if it is not applicable)
Students joining Certificate and Diploma in Psychological Counselling are entitled to subsidized counselling sessions as they meet an important course requirement. The sessions are a critical part of licensing, accreditation and learning. Information shared here just like in page one is secured and treated with utmost confidentiality. The information collected here helps us identify a counsellor whose portfolio speaks to the realities of your personal needs
Personal information
Title Name & Mobile Religion Age Nationality
Marital Status
Have you been previously counselled?
Rewrite your response in the box
Yes No if yes by whom (Name and Title)
Issue (s) of concern
Are you aware of specific issue you can share with your therapist? Susan Gilmore, one of the psychological minds of our times explains what people brings for counselling through three pillars notably; Relationship, work, Identity. Rewrite or type your concern
Preferred Counsellor
See the details that makes you comfortable
Day and time of the week when available for therapy
Do not overthink about it because you will mutually agree with your counsellor on what works best for the two of you once you have been assigned a contact.
Will you rather have your sessions online or on-site ?