All data collected from this enquiry form is considered confidential, kept in our service database and unless an information release form is explicitly provided, this information will not be shared with anyone.
We use the information gathered from this form to help us to best respond to your enquiry.
Please work your way through the following questions and note that those marked with a red asterix require answers. When you complete the questions and select "submit", you can expect an automatic response to the email account you provide.
If you feel uncomfortable about using this form or if you don't have an email address please call (03) 525 9624 ext. 5 to speak with our Intake Coordinator.
Thank you in advance,
The DBT Team.