clinical referrals

Refer your clients for private, 1:1 trauma-informed yoga classes here - virtually, anywhere they are.

Thank you for considering our trauma-informed yoga services for your client. We appreciate the trust you place in us as part of your client's therapeutic support network.

Important Information:

Sessions are offered privately at $140 per session (virtual delivery)
Discounted rates available: 5-session package or 10-session package
Limited availability - applications usually reviewed within 3 working days
Not all referrals can be accommodated due to capacity and scope of practice - we can work with you to refer to an appropriately qualified trauma-informed or TCTSY qualified yoga facilitator if appropriate
Virtual sessions available Australia-wide and internationally; in-person sessions in Ocean Grove, Victoria

Your details

First name

Last name

Role (possibly including qualifications/practice and relationship with person being referred)

Phone

Practice name

Client details

Clients' full name

Clients' email

Clients' phone

Client's preferred method of contact

Phone call

Text

Has the client consented to this referral?

Yes

Primary reason for referral

Please describe what you hope trauma-informed yoga might offer this client as part of their broader support

Current treatment or support

Brief overview of current therapeutic work, relevant diagnoses, or presenting concerns that inform this referral

Relevant considerations (including accessibility needs)

Physical injuries, mobility needs, dissociation, sensory sensitivities, trauma history relevant to movement practice, medication affecting balance/coordination, etc.

Where are they looking to practice yoga?

Virtually from home

In studio in Ocean Grove VIC

What time of day/days of week might suit this client (and any other logistics consdierations)

Is there anything that would be helpful for us to know ahead of considering this referral?

This is a confidential space. You might like to share about physical injuries, relevant mental health info, your neurotype, what you're nervous about, or anything at all you feel is relevant.

What is your preferred next step?

I'd like to book a 15min chat to discuss this referral (or others) - link on next screen

Something else (let us know below)

Supporting Documentation (optional)

If you have supporting documentation or anything from the client you'd like to share please feel free to share below or upload that here.

Supporting info/something else

File upload