Group Interest Registration

Please complete the below information to register your/your child's interest for group.

Please be aware group dates are subject to clinician availability, groups do not run on a regular schedule, registering your interest means you will be contacted with the next available group (or information about a similar group). For information about what each group covers please see here: https://uniqueupsychology.com.au/group-therapy/

Participants Name*

First NameLast Name

Parent's Name (if applicable)

First NameLast Name

Phone Number*

E-mail*

example@example.com

Date of Birth*

Date

Age

Group Programmes

Neuroaffirming Interest Group eg. art & craft, gaming (Primary age)Neuroaffirming Interest Group eg. art & craft, gaming (High school age)Friendly U (10-12 years)Celebrating U Together (13-16yrs)Celebrating U Together (17-19yrs)My Unique Brain (Adults)Uniquely U (Adults)Other group listed on the website (please provide further details below)

Holiday Workshop - (1 session 1-2 hours)

Interest based group (primary age 8-12yrs)Interest based group (aged 13-18yrs)Other (please provide further details below)

Other information:

What Group Time Suits You?

Mode of Delivery*

Online (via telehealth)In person