Refer

If someone close to you, whether a friend or family member, could benefit from expert guidance and a listening ear, you're in the right place. Our network of trusted therapists and counsellors are ready to provide the compassion and insight your loved one needs. Help them take the first step towards healing and growth by referring them to our handpicked professionals. Strengthen the bonds of care by offering the gift of professional support on their journey to well-being.

Refer to Lyfetree Therapy and Counselling

Please fill out this referral form to connect someone you care about with our therapy and counselling services. Your referral could be a friend, family member, or anyone who could benefit from therapeutic support.

Your Information

First Name

Last Name

Phone

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Referred Individual's Name

First Name

Last Name

Referred Individual's Email

Referred Individual's Phone Number

(###)

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Relationship to Referred Individual

Address

Is the client/participant to be privately billed or are they funded

If the client/participant is funded, who is the funding organisation?

What services are you interested in?

Trauma Psychotherapy

EMDR Preparation Sessions

EMDR Processing Session

Grief & Loss Therapy

NDIS Participant Therapy

VOCAT Therapy

Kids Emotional Regulation Therapy Ages 4-10

Family Relationships Support for Carers (FRSC)

Additional Notes

I understand that by submitting this referral form, I am giving consent for the referred individual to be contacted by the therapy and counselling team. I confirm that I have obtained the referred individual's permission to share their contact details.

Agree