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Registration Form - Online Counselling

If you would like to register for GamCare online counselling, please fill in your details as prompted below. Please note that * indicates a mandatory field.

Please also read our Terms and Conditions.

Our service is only funded to provide treatment to those living in England, Scotland and Wales. If you are outside of the UK, please access Gambling Therapy - a free, multi-lingual online service, via

Please note that submissions via this webform are checked between Monday - Friday, 9am-5pm. If you are submitting outside of these times and require urgent support, please contact the National Gambling HelpLine on 0808 8020 133 or via our NetLine.

If you are in crisis, please contact the Samaritans on 116 123, or in an emergency please contact 999.

We will communicate with you to confirm or cancel appointments and for follow ups after treatment. We will generally communicate by email, but there may be time when we need to call you.If you are not happy to be contacted by phone please indicate this here:
Please provide the name of the householder and the address where these children or vulnerable adults live.
If you are not the gambler, please answer to the best of your ability.

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