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Please complete an intake form below if you are a new client wanting to book in with Bianca. ​

For more information about rebates and appointments, please visit the FAQs tab. 

Adult Intake Form

Date of Birth
Day
Month
Year
Do you have, or plan to access, any funding or rebates for sessions?
Medicare rebate (GP Mental Health Care Plan)
NDIS (self-managed only)
Private health insurance

We acknowledge the Traditional Custodians of Country throughout Australia and their continuing connection to land, waters and community. We pay our respects to Elders past, present, and emerging, and extend that respect to all Aboriginal and Torres Strait Islander peoples today.

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