Referral, Client forms and fee information

Here you  will find all the forms you will need as a client of Sanctuary Counselling and Consultancy.

Please download and print them, so you can fill them in. If you do not have a scanner or access to a scanner, simply take a clear photo of them, once they are filled in and email them to trish.sanctuary.counselling@gamil.com

Payment Details

Sessions are at a set price of $100 AUD per session. As the client, you are responsible for ensuring payment is made on the day of therapy, at every therapy session.

If you are requiring reimbursement from you employer or insurance, then that is your responsibility to organise. 

A late fee of $25 AUD will be charged if your fee is not paid within 5 days of your session, unless contact is made to notify that a payment is pending.

You can request help for payment of your fees. Simply mention it in session or send an email to trish.sanctuary.counselling@gmail.com and we can organise a plan for you.

Payment option:

Cash - in person

Card - in person

Card - via internet - Square Site Merchant (please note this link will take you to the Square Merchant site).

Direct deposit - I can give you those details via email. If you use this option, please put your name in the description section.

To download or print the documents, click on the arrow in the righthand corner at the top of each one, it will load in a different tab, from there, at the top on the right, you can click on the download arrow or the print icon.
If you do not have a scanner or do not have access to someone else's scanner (at a library, or a friend/family member, then you can take a photo using your phone. Please ensure all text is clear and readable.
If you do not have a printer, scanner or phone, then you can wait for your session to come about and fill in the forms then... snail mail is an option for getting the relevant forms filled in and back to me. If you choose snail mail, then please either email (trish.sanctuary.counselling@gmail.com ) or ring/text  (0490 903 319) me for the postal address.

Last updated: 14 November 2023