Intake form

Name

Phone Number

Where in the world are you located in?

Date of Birth

How did you hear about me?

Employment

Marital status

Any substance use or alcohol dependency

Current/history of suicidal ideation and self-harm

Anything else that you think is helpful to mention before your initial session

Oakwisetherapy

At Oakwise Therapy, we believe in the power of compassionate support to inspire positive change and create a space where resilience is cultivated, and transformative healing unfolds.

Quick Links

Our Services

Individual Counselling

Couple Counselling

Contact Details

Phone: (02) 8006 0632

Email: zohreh@oakwisetherapy.com.au

Intake Form

Oakwisetherapy

Quick Links

Our Services

Contact Details

2023 © All rights Reserved. Oakwise Therapy