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Client Details

Patient

Thank you for your enquiry.

This short form helps determine suitability and availability at Soluna Psychology. It should take approximately 2–3 minutes to complete.

This form is not monitored in real time and is not suitable for urgent or crisis support. If you are at immediate risk or need urgent support, please contact your GP, Lifeline (13 11 14) or emergency services (000). 

Please note: Completion of this form does not guarantee an appointment, but helps ensure we can offer the most appropriate support.

Patient Details

Phone Numbers

* Mandatory questions