Online DBT Group Enquiry Form

Location

Which clinic are you enquiring about?(Required)

Client Details

Client Name

First Name(Required)

Last Name(Required)

Date of Birth(Required)

Gender

What are the correct pronouns?

Contact Number(Required)

Email Address(Required)

Address

Street Address(Required)

Address Line 2

Suburb(Required)

State(Required)

Postcode(Required)

Are you a current client of a Sydney Psych Hub psychologist?(Required)

Yes

Have you attended group therapy previously?(Required)

Yes

General Information

How did you hear about us(Required)

Policy

Cancellation - We ask that clients contact the clinic no later than 48 hrs before your appointment if you are unable to attend, please cancel at your earliest opportunity via phone, text or email so that the appointment can be made available to others. In the event you don’t, a cancellation fee will be incurred. This policy is explained during intake and at the initial appointment with your psychologist.

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