Client Registration Form

Client Details
I consent to Relationships Australia WA contacting me at a later date to ask me how I experienced the service.

Disability needs



Below is important information about your right to confidentiality and privacy. Please read this section prior to accessing our services.
Client information & confidentiality
Client Information and Confidentiality explains how we will treat your confidential information. We recommend that you read this prior to your session. If you are unclear about anything please ask your practitioner when you meet with them.
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Privacy and your information
Relationships Australia is committed to your right to confidentiality and privacy. This information details the conditions of receiving a service from Relationships Australia WA.
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As a parent/guardian, I agree on behalf of a young person under 18 years