If you would like to request an appointment at Mind Body Well please complete and submit the form below. We will respond within 24 hours of receiving your request.

PLEASE NOTE - we are not a bulk billing service, all sessions will incur an out of pocket fee. You may be eligible for Medicare or Private Health Insurance rebates for our therapies, see details about claiming rebates for therapy at THIS LINK.

Prior to submitting your intake request, please familiarise yourself with our INFORMATION AND FORMS.


New Client Appointment Request Form

Please complete all details with * symbol, and other details as relevant. Your form will be sent to us after you press SUBMIT at the end, and you are directed to a page which says ‘Thank you for making contact’.

Name *
Name
What type of therapy are you seeking? *
What days / times are you available for appointments? PLEASE NOTE - appointments outside business hours are limited. *
Please select as many as possible that apply
Click to select, or leave blank if n/a
I have read and agree to the conditions stated on the Mind Body Well New Client Information Form *
I am aware of, and agree to adhere to the Mind Body Well appointment cancellation policy. I agree to be financially responsible for appointments not attended, or those cancelled with less than 48 hours notice *