Oogachaga Counselling Request Form
This form is to be treated as a confidential record when it has been completed and submitted to Oogachaga.

We recommend that the person receiving the counselling to fill in this form, as detailed information is required. The information provided here will enable the Counsellor to prepare to meet you and offer appropriate support.

You will be contacted within the next 3 to 5 working days with further details about your counselling request. Please check your email message inbox or spam folder.

If you do not hear from us after 1 week, please contact us directly by phone or email.

Thank you.

Case Manager
tel: 6224 9373 (call Mon-Fri: 11am-6pm)
email: counselling@oogachaga.com

Note: The asterisk (*) refers to mandatory fields.
  • / /
  • About your counselling needs

  • For couple or family counselling services, please tell us more about the other people who may be attending with you:

  • Contact details of next-of-kin / person to contact in case of emergency (optional).