top of page

emerge
counselling

Home
About Us
Testimonials
Pricing
Contact

Contact

Interested in our services?

Please complete the expression of interest to engage in counselling

First name*

Last name*

Birthday*

Month

Day

Year

Email*

Phone*

Type of counselling*

Where you will be attending with someone else

Name

Relationship (Eg partner, parent, carer)

Age

Preferred Counsellor*

Session format (Kate)*

Session format (Dave)*

I would like support with (select all relevant options) - Kate*

Grief and loss

Working through a traumatic event(s)

Addiction

Relationship challenges

Parenting challenges

Depression

Anxiety

Significant life changes (career, relationship, health issues)

Childhood challenges

Adolescent challenges

Low self-esteem

General mental health support

Other

I would like support with (select all relevant options) - Dave*

Fatigue after stroke

Rebuilding life after stroke

When did you have you stroke(s)? - Dave*

What challenges are experienced as a result of stroke? (Select all relevant options) - Dave*

Physical limitations

Challenges with cognition & memory

Communication challenges

Mental health challenges (low mood, increase anxiety etc)

Other

Please provide details of options selected above - Dave *

Preferred days and times (select all relevant options) - Kate*

Monday PM

Monday late arvo (after 3:30)

Tuesday AM

Tuesday PM

Tuesday late arvo (after 3:30)

Thursday AM

Thursday PM

Thursday late arvo (after 3:30)

Friday AM

Friday PM

Friday late arvo (after 3:30)

Please specify any specific requirements

Preferred days and times (select all relevant options) - Dave*

Tuesday AM

Wednesday AM

Thursday AM

Please specify any specific requirements

Any other relevant information

Contact Information

Dave: 0488 822 967

dave@emergecounselling.com.au

Kate: 0488 822 968

kate@emergecounselling.com.au

Hours of Operation

By appointment

Address

31 Florence St

Murray Bridge

(enter off Charles St)

bottom of page