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Client Referral Form

Please complete the referral form below. All information is treated confidentially, and the client will be contacted within 24–48 hours to arrange an initial consultation.

Current Availability: Accepting new clients for online sessions (weekdays & limited evening appointments available).

If you’d prefer to discuss a referral before submitting, feel free to get in touch.

Phone/ Text

0434 024 091

Email

Social Media

  • LinkedIn
  • Instagram
  • Facebook

Referrer name

"Echoes in Solitude Counselling will only use this information for the purpose of providing counselling services. All information is handled confidentially and securely."

Client name

Upload File
Upload supported file (Max 15MB)

Please upload any relevant documentation to support this referral, such as referral letters, clinical reports, or NDIS plans (if applicable).

Thanks for submitting!

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Registered with:

Practice details:

Tim Chu, Master of Counselling

 

Online counselling Australia-wide

Gold Coast / Brisbane

 

Email: tinhangc.counselling@gmail.com

 

Phone/Text: 0434 024 091

 

ABN: 21 521 028 321

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