Intake Form

Flourish Therapies require attendees to complete and submit the below form prior to their first session.

Alternatively this is available to download (bottom of the page), complete and bring with you to the session.


    I agree that Flourish Therapies can communicate with my emergency contact ONLY in the event that they are concerned about my safety/ wellbeing or that of another individual.

    To ensure the welfare, privacy and wellbeing of our clients, we operate within strict service agreement and consent terms, which we will ask you to read and sign.

    Confidentiality is a priority of Flourish Therapies. All information that is gathered is treated as strictly confidential and stored securely. We adhere to the Health Care and Professionals Council privacy policies and protocols.

    Your therapist will need to collect and record personal and health information that is relevant to your current situation. This information is treated in the upmost confidence.

    Intake Form Download

    Click to download PDF Intake Form

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