top of page

New Client Form

Thank you for your interest in Two Minds Clinical Practice. 

​

Before booking a first appointment, we ask that you please start by completing our New Client Form below. Please answer each question as honestly as possible. This helps us make sure we can allocate you to the right clinician and provide the best service for you.

​

If you have a more general enquiry, would prefer to chat to us, need help completing this form, or would like a PDF version, please email or phone us.

​

Two Minds Clinical Practice would like to emphasise that your privacy and the information that you provide is stored securely and protected at all times. Your personal information is gathered as part of allocation and to support your treatment. 

New CLIENT FORM

If you are completing this form on behalf of someone else (e.g. a family member, friend, or client), please ensure that you have their consent and that they are motivated to engage with us. 

Please select if you have any of the following funding options
Which clinician would you prefer to see?
Please select all days that you are available.

Thank you for taking the time to complete this form as honestly as possible. We will endeavour to respond to your enquiry as soon as possible – typically within 1-2 business days. If you have any queries or concerns, please phone or email us.

bottom of page