If you are a new client, please read my ‘services’ pages first and then complete this form to
see how we can best work together:

Name

What are your main reasons for seeking therapy?

Have you seen a therapist before? What worked/didn't?

Are you in a crisis situation?

Do you have any questions for me?

I acknowledge the Traditional Owners & Custodians of the land on which I work and live on. I pay my respect to the Traditional Owners past, present & emerging.

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