Register as a client

We invite you to register here for our services.

Your details

Your first name *
Your phone number *
Your last name *
Your email *
Your address *
Your date of birth *
Your postcode *
Your gender
Your suburb *
Do you identify as Aboriginal or Torres Strait Islander?
Your primary diagnosis
If you already have a primary diagnosis, please describe it here.


Funding sources (check all that apply)

Services you are seeking

Outline the services you require
Current concerns
Tell us about your current concerns or needs
Prior to our assessment, what frequency of treatment are you contemplating, eg, weekly, fortnightly, etc)