Onboarding

🎉Let's Get You Started !

We’re excited to join you on your journey to transform your life! Please fill out the form below.

Onboarding Form

First Name *

Last Name *

Email *

Phone *

City/Suburb *

Date of birth

Whats going on? What is the main challenge you would like support with? *

How long has this been affecting you? *

If we were speaking 90 days from now and this challenge was resolved, what would be different in your life *

On a scale of 1–10, how committed are you to creating change in this area?

What have you already tried? *

Why is now the right time to address this? *

Are you currently experiencing thoughts of harming yourself or others? *

Yes

No

Please acknowledge *

I confirm that I am not currently experiencing an active mental health crisis, suicidal ideation, psychosis, or any condition that would require immediate medical or psychiatric intervention.

Acknowledgements *

I understand this program is educational and personal-development focused.

I understand this program is not psychotherapy, counselling, psychology, psychiatry, or medical treatment.

I understand no specific outcomes or results can be guaranteed.

I accept full responsibility for my own decisions, actions, and results.

I understand I may be referred elsewhere if this program is not deemed appropriate for my needs.

I understand I may stop participation at any time.

Signature *

Clear

Date *

COMPANY

LEGAL

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TERMS OF USE

client onboarding

ADDRESS

Northern Rivers & Online Worldwide

0474 989 082

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