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Love Well Counselling - Client Intake and Consent

Before Your First Appointment


Complete three steps: your details, counselling consent and optional insurance. Required fields are marked *.


Your FaceTime or Zoom invitation will arrive separately by email or text. Please discuss questions with Mark before agreeing.


Do not include medical histories, payment details or government health numbers.

Date of birth
Year
Month
Day
Residential address
Communication preferences (optional)
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