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Consultation

Liight Me Up Again > Consultation


    Liight Me Up Again Services

    ABN:48532028139

    Client Intake Form – Consultation

    Thank you for choosing Liight Me Up Again Services. This form helps us understand your needs, goals, and preferences so we can provide effective, tailored consultation support.



    Client Information:






    Emergency Contact



    Referral Information



    Referrer Details



    Self-ManagedPlan-ManagedAgency-Managed


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    AboriginalTorres Strait IslanderBothOther Indigenousnon-indigenous


    YesNo

    Section 1: About You/Your Organisation


    YesNo


    Section 2: Consultation Goals & Needs




    Section 3: Focus Areas

    NDIS & Social Work Consultation (plans, advocacy, systems)Personal Development / Transformation / Relationship / Recovery / Mindset ConsultationCareer & Leadership ConsultationOrganisational / Community ConsultationOther

    Online (Zoom/Phone)In-person (local only)

    Section 4: Agreement & Boundaries*


    • I understand that consultation is not therapy, counselling, or medical treatment.
    • Consultation provides strategic advice, clarity, and practical solutions based on professional experience.
    • I understand that this form and all materials provided are for my personal use within session and remain the property of Liight Me Up Again Services. I agree not to reproduce, share, or distribute these materials without written consent. I have read and agree to the Service Agreement.
    • All information shared remains confidential, except where disclosure is required by law (e.g., risk of harm, suicide/self-harm, child or vulnerable adult protection).
    • I acknowledge that I am responsible for my own choices, decisions, and outcomes.
    I agree and consent to consultation under these terms.





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