Patient Enquiries

If you are a patient seeking support, you can use this form to get in touch. Whether you would like a second opinion, a personalised TMS treatment protocol, or to learn more about how our services may help, we will review your enquiry and respond with guidance on next steps.

Full Name *

Phone *

DoB. *

Email *

Reason for Enquiry?

What would you like support with? *

Current Diagnosis / Main Concerns

Have you been diagnosed with a mental health or neurological condition?

If yes, please specify.

Previous / Current Treatments

Are you currently in treatment? *

Current Medication?

Which areas of the brain targeted?

Condition being treated?

How many sessions completed?

What Protocols were used?

Inhibitory, excitatory, iTBS, cTBS, Saint protocol etc?

Healthcare Provider Details

If you are undergoing treatment at the moment or have previously.

Treatment Centre details

Clinician Details

Additional information

Please share anything else you feel would help us understand your situation.

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