Referrals & Intake

We are here to find the right support for our clients and their families

Please fill out the referral form below and we will get in contact with you within 3 business days. Alternatively, you can also request a referral form to fill out and send it to us via email:

Referral & Intake Form

Please fill out as much information as possible. Thank you.

  • Date Format: DD slash MM slash YYYY
  • Referrer Details

  • Client Details

  • Date Format: DD slash MM slash YYYY

Fax (02) 5747 4153

Greater Sydney Suburbs & Online Counselling Services

Hours & Access