Medical referral
Please print and ask your GP or relevant clinician to complete this referral where requested.
Print and completeForms in one clear place.
Only the two forms marked Required are normally needed; the remaining questionnaires are optional. Completing a relevant optional form can save time during assessment.
Declaration of health condition (COVID-19)
Complete the health declaration before an in-person appointment when requested.
Complete onlineQuestionnaire for new clients
Helpful background information that can save time during the initial assessment.
Complete onlineClient–Hypnotherapist Feedback
A confidential feedback form about your experience of the therapeutic process.
Complete onlineOvercoming procrastination
A focused questionnaire for clients working with procrastination and motivation.
Complete onlineWeight Loss Management
A focused questionnaire for clients seeking support with weight-management habits.
Complete online