Counselling Referral Form

Please fill out the form below to refer your clients to us.

Thrive Clinic Client Referral Form

This form gives us some specific details around your clients needs and goes directly to the Clinic Director Sean Tonnet. An assessment will be made from this information supporting your clients best fit service entry and intake. Of course, we will collaborate with you to ensure certainty in your referral request.

Is the Client aware of and agreeable to the referral? *
Is this referral urgent? *

Client Information

May we email your client? *

Note: Email is not considered to be a confidential medium of information

Referring Professional


0415 919 123


138 Dalley St, Mullumbimby


Mon-Fri 9am – 5pm