This form allows you to express interest in receiving services from Contemporary Therapy Solutions. Completing this form does not guarantee services, but it helps us understand your needs and ensure we are the right therapist to work with you. Please complete a new form for each interested person.

If you are completing this form on behalf of a person with disability, please provide the most appropriate contact details for discussing service options. Please answer all questions as accurately as you can.

Any information collected from this form will be kept confidential. If we are unable to offer a service to the person expressing interest and they do not wish to remain on a waitlist, their information will be deleted. The person’s contact details will only be used for the purpose of discussing services, unless otherwise specified.

If you would prefer to complete this form over the phone, please email your phone number and availability to admin@contemporarytherapy.com.au or contact Rachel on 0494 614 417 and we will get back to you within 5 business days.