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Student Self Referral for Counselling
To book counselling for yourself, please fill in the form below. All information is confidential.
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* Indicates required question
Your Full Name
*
Your answer
Year Level
*
Your answer
Your Email
*
Your answer
Please tell us about your problem or concern...
*
Your answer
Appointment Time
*
Extremely urgent - safety is a concern
As soon as possible
Not urgent
Name of preferred counsellor, if any.
Your answer
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