New client intake

Welcome — let's get to know you

Before we meet, this helps me understand your story, your health background and what you're hoping to work on — so our first consultation can begin with the real conversation, not paperwork. Take your time. There are no wrong answers, and you can write as much or as little as feels right.

Private & confidential — seen only by Deb
Step 1 of 8 A little about you

A little about you

Just the basics so I know who I'm meeting and how to reach you.

What brings you here?

Tell me in your own words first — then a few quick prompts to round it out.

Your health background

A picture of your history helps me see the whole story. Share what you can remember — approximate is fine.

Medications & supplements

This one matters most. Knowing exactly what you take lets me check every recommendation is safe alongside it. Please include everything, even occasional things.

Add a row for each medication.
Add a row for each one.

Food & daily life

How you eat, move and fuel your days tells me a lot about what your body needs.

Sleep, energy & mood

These three shape almost everything. Slide to whatever feels closest — there's no perfect number.

5
PoorExcellent
5
DrainedEnergised
5
CalmVery high

A few last questions

Only answer what feels relevant to you. You're always welcome to skip anything.

Only if this applies to you — feel free to move on.

Almost there

Two last things, then you're done. Thank you for trusting me with all of this.

Before you send this

Everything you've shared is kept private and confidential, stored securely, and seen only by Deb as part of your care. It is never shared without your permission, except where required by law. Naturopathy, clinical hypnotherapy and psychotherapy are complementary therapies and are not a substitute for medical advice or emergency care — in an emergency, always call 000. For full detail, see our Privacy Policy, Terms of Use and Health Disclaimer.

Please add your name (step 1) and tick the consent box so I can receive your form.

Thank you, it's all come through

I've received your intake and I'll read it properly before we meet, so our first session can start with the real conversation. If anything needs clarifying beforehand, I'll be in touch. Look after yourself until then.

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