Downloads

The below provides a brief explanation of the new client form to make it easier to complete. We encourage you to complete as much of this as possible before your first consultation and we can support you with anything else that you are unsure of then.

Helps us to learn a little more about you, your motivations and any other support mechanisms you have in place.

Each row represents a different goal. This will assist us to focus on what’s most important to you.

Example;

Desired Outcome (Goal) - What you want

“Have a happy, loving relationship/marriage” | “Earn $_____ p/a doing what I enjoy” 

“Achieve and maintain my ideal weight of __ kg.” | “Be a non smoker”

How will you feel when you have it

Loved, appreciated, worthy…..

How you feel now without it.

Frustrated, sad, angry…. 

Is an emotional life summary up to age 21. (Research shows that the programming we receive in our early years can dictate our emotional patterns for life.) 

Include your age at the time, a brief description of events and how you felt. Remember there is no right or wrong, it just is. If you were told about your birth include that as well and anything else that you can remember. If you don’t remember how you felt just imagine how someone else would have felt in the same situation.

• Born premature or forceps delivery not sure how I felt probably lonely & afraid.
• 2 yrs old first day at child care, cried a lot felt sad and anxious.
• 2 yrs old my baby sister was born, felt jealous angry & unloved.
• 4 yrs old migrated to Australia missed my friends & favourite auntie felt lonely and angry at parents.
• 5-15 yrs Dad was very authoritarian and often hit me. Felt stupid, guilty, anxious and angry.
• 8-12 yrs bullied at school felt fear, angry and helpless.
• 11 yrs old Fell out of a tree broke my right leg.
• 12 yrs. Mum bought me a second hand uniform for first day at high school. Felt poor, not good enough.
• 14yrs. My dog Freckles died, (hit by a car) I blamed myself felt guilty, sad & angry.
• 15yrs. My girlfriend/boyfriend dumped me and went out with my best friend. Felt hurt and sad.
• 17yrs. Parents separated & injured in car accident (leg knee & head injuries). Sadness, fear & anger