St. John's Cathedral Counselling Service.
Thank you for your interest. Please complete this questionnaire and wait for our staff to contact you for an appointment with our mediators.

Please note that individual sessions range from $1250 to $1800 per session whilst couple/family sessions range from $2000 to $3000 per session depending on monthly family income and assets. Your mediator will also let you know if there is any additional charges that may apply when documents and/or reports are required.
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Full Name (Surname in CAPS) *
Gender (Identified) *
Age *
Contact Phone Number *
Contact Email *
What is the dispute requiring exploration and resolution through the mediation process? *
Who are the other parties involved in the dispute (their identities, roles & functions)? And how are they involved? *
Are these other parties willing to try mediation? *
Are you currently, or will be, involved in legal proceedings over these issues? If yes, give a brief description please. *
Have the disputing parties (including you) sought third party help (such as professional views, legal advice, psychiatric help, etc.)? If yes, please give details. *
Number of family members in your household (including yourself)? *
What is the HK$ monthly income of your household (including yourself)? *
What language do you prefer to use? *
What days and times work best for you to set an appointment? Please tick all that apply)
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Is there any additional information that you would like to know?
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