First Intake Session with Vera (75-90 mins) RM250

5:00 am - 6:30 am

Fri, May 9, 2025

5:00 am - 6:30 am, Fri, 5/9/2025

We'll meet on a web conference

Welcome to your first step toward healing and growth! If this is your first therapy session with us, please select the First Intake Session... more

First Name

Last Name

Confirm Email Address

Age

Date of Birth (DD/MM/YYYY)

NRIC / Passport Number

Gender

MaleFemale

Current Address

Contact Number

Nationality

Preferred Language

EnglishMandarinMalay

Emergency Contact 1 (Name, Relationship to you, Phone Number)

(E.g., Thomas, Spouse, +60123456789)

Emergency Contact 2 (Name, Relationship to you, Phone Number)

(Eg. Mary, mother, +60123456789)

Have you had any thoughts of ending your life?

Have you considered or made plans on how you might end your life? Do you intend to carry out this plan?

Reschedule and Cancellation Policy (https://mindwavepsy.com/terms-and-conditions)

I have read and agreed to the 24-hour notice policy for rescheduling and cancellation (as stated in 'SECTION 3' of the Terms and Conditions)

Terms & Conditions (https://mindwavepsy.com/terms-and-conditions)

I have read and agreed to the Terms and Conditions, including confidentiality, risks, cancellation policy, payment, and client rights.

Age Requirement

I hereby confirm that I am 16 years old or above

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