Fill out Form Bellow Name * First Name Last Name Email * Phone (###) ### #### What services are you interested in? * Neurofeedback and Counselling in Preston VIC 3072 Neurofeedback and Counselling outreach, 30 min drive from Sunshine VIC 3020. Online Counselling Counselling Only in Preston VIC 3072 Counselling Only outreach, 30 min drive from Sunshine VIC 3020. What area/s do you need help with ? * Choose 1 or more options. PTSD Stress Anxeity Depression Neurodiversity (ADHD/ASD). Relationship issues (Individual) Relationship issues (Couple) Addiction Sleep Problems Work Performance Peak Performance (Neurofeedback) Improve Executive Functioning Brain Seizures Funding Source * Self funded Family/Friends are paying I have VOCAT funding My Case Manager will apply for FSP (flexible support package) My Case Manager will apply for other funding I have an NDIS Plan that includes counselling I have an NDIS Plan , not sure if It includes counselling. I have Private Health Insurance How did you hear about us? Social Media Recommended by someone Google Search Psychology Today Other (please specify) Additional information, your Story. Optional QUESTIONS ? ? ? Optional Thank you!
