Name
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First Name
Last Name
Phone
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(###)
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Email
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How did you find me?
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If you were referred by a past / current client of mine and you / they feel comfortable doing so, please include their name below. This is important to help me determine any potential conflicts of interest.
Are you looking for short- or long-term support?
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Short term therapy is best if you are wishing to obtain assistance with a specific difficulty in a time-limited period (i.e., up to 6 months). Long-term therapy is best if you are wishing to obtain long-term support, obtain assistance with a number of difficulties that may have been experienced over a long period of time, and/or are wishing to explore your early life experiences, relationships, and/or traumatic experiences (generally 6 months +).
Short-term
Long-term
Please provide a brief description of what you’d like to explore together.
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Please provide a brief description of any therapy you have engaged in so far. What did you do (if known), what was helpful (if anything) and what was unhelpful (if anything)?
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What commitment are you willing/able to make to therapy? (Select all that apply)
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Research supporting the effectiveness of psychological therapy is generally completed with clients who attend at least weekly sessions. Fortnightly sessions are an acceptable option if you are unable to commit to weekly sessions, or if you have already completed dedicated psychological work previously. I do not offer monthly or ad hoc sessions for new clients.
Twice-weekly
Weekly
Fortnightly
Cancellation Availability
If you are interested in bypassing my waitlist, there may be an opportunity for me to offer you appointments based on cancellations. If this interests you, are you available to attend last-minute appointments? This is only appropriate for those who are able to respond to appointment offers (via SMS or email) on the same day they are sent, and who have the flexibility to attend appointments at short notice (e.g., 48 hours). With this option, I cannot guarantee frequency of sessions and you will not have a dedicated appointment time.
There are some difficulties that I don't work with, which may be due to my own preference, limitations inherent with the nature of working as a solo practitioner (as opposed to in a group practice), and/or my own experience and training.
If any of the following are relevant to you - even if they are not what you are hoping to work on - I may determine that I am not the best practitioner to be working with you.
- Difficulty in respecting others' boundaries;
- Inappropriate expressions of anger toward others that you have close relationships with, either verbally or physically;
- Significant suicidality, which may include recent suicide attempt/s with or without hospitalisation.
Please provide further details below if any of the above are relevant to you.
Limits to my services
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There are some important limits to my services. Please acknowledge all of the following:
I have a 48 hour cancellation policy, otherwise my full fee is charged (view my Fees page for more info).
I’m only available for contact and appointments during business hours (excluding public holidays and periods of leave).
I don’t offer services to those under 18 years, DVA, CDMPs, EDPs, WorkCover, couples, or families (though, I do offer individual therapy for relationship difficulties).