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Registration Form

Personal Information

Gender
Male
Female
Date of Birth
Day
Month
Year

Type of Session

Please select the service you wish to book:

Background Information

Have you received counseling or therapy before?
Yes
No
Are you currently taking any psychiatric medication?
Yes
No
Schedule an appointment
October 2025
SunMonTueWedThuFriSat
Week starting Sunday, October 19
Time zone: Coordinated Universal Time (UTC)Phone call
Friday, Oct 24
10:00 AM - 11:00 AM
11:00 AM - 12:00 PM
12:00 PM - 1:00 PM
1:00 PM - 2:00 PM

Please share two or three preferred days/times that suit you. Our admin team will contact you within 24–48 hours to finalize your appointment and send the meeting link.

Payment Information

Session Fee: 45–50 min session
A$60
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