New Clients

Thanks for having the confidence and courage to seek change. Please complete the following form, submit it, and we can begin the journey together.

If under 18 years of age
Please select the most appropriate option
Home address
A phone number that you can be reached on
If you were referred to me by someone
Have you previously had any type of counselling, coaching, supervision, psychology or psychiatry service?
Please tell me who your previous therapist/s are