New Clients - Appointment Request

Emotionally Focused Therapy and Training Australia is a private psychology and psychotherapy practice.

Client 1 full name:
Client 1 phone contact:
Client 1 email:

Are you enquiring about couples/relationships therapy?

If you are enquiring about couples/relationship therapy, please include details for Client 2 below. Please note: If you include Client 2 information we will reply to BOTH of you with appointment availability and further information. If your enquiry is for individual therapy, please skip the Client 2 section.

Client 2 full name:
Client 2 phone contact:
Client 2 email:
Therapy requested:
Not sureIndividualCouples / RelationshipFamilyChild (10+) or Adolescent
Appointment mode:
In personTelehealth/online
Preferred therapist:
No preferenceNick BakerDiane BallardDr Jenny FitzgeraldStuart HendersonDr Jenni Wilson
Reason for appointment request (please tick all that may apply):
AddictionsADHD/ASDAdjustment disordersAnxietyDepressionGrief & BereavementLGBTQIA+Life transitionsParenting issuesRelationship distressTrauma/PTSDSeparation / DivorceSexual issuesStressOther/Rather not say
Your message (optional):
Notes:

• Mental Health Treatment Plans can only be used for Individual Therapy with a Psychologist.

• If using Private Health for Individual, Couples/Relationship or Family Therapy please check with your provider for eligibility. If booking with a Psychotherapist, please refer to their profile page for applicable Private Health Fund providers.

• EFTTA does not provide services for Tapping (Emotional Freedom Technique), we provide Emotionally Focused Therapy.