It is wonderful that you have chosen to engage with a clinician at Eat Love Live. 

This form is optional, but has been designed with two purposes in mind:

1. Firstly, if you are unsure which practitioner would be the right fit for you, our Clinical Director and client service team will review the information you have provided and make suggestions.
2. Secondly, this is an opportunity for you to provide information to the clinician you have chosen to make an appointment with. There may be lots of information you wish to share and are worried it won't all be covered in the initial session - or that you may forget something. 

Reflecting on your answers before the session may help you to develop a clearer understanding of the goals you would like to work on with your clinician.

If you are worried that reflecting on your medical, dietary or mental health history may be distressing or triggering in any way, please know that it is ok not to fill in this form. The information can all be gathered by your practitioner in the initial consultations in a supportive manner to avoid undue stress.

Privacy

This form will only be viewed by our Clinical Director and our client services team for the purposes of triage or allocation to the correct file.  This form will then be stored in your medical record and viewed only by your practitioner. 

You will complete a New Client form prior to your session which will gather all the relevant personal information. This will be provided to you by reception and includes further information about privacy and confidentiality.

Referrals

If you have a referral from your GP you can forward this to reception@eatlovelive.com.au however you do not need to have a referral to make an appointment.

Please note this form does not act as a booking.