Intake form

Please download the intake form using the buttons below. 

Once you have filled out the intake form, please email it to

We will then get in touch with you soon after.

If you have any questions about the above form or about the services we provide, Please contact one of our Team Members on the below details.

Phone: (07)44262770


In Person: Dalgety Building, 103 Denham Street, Townsville City,4810

Mail: PO BOX 588, Townsville City,4810


Wulli Wulli acknowledges and pays respect to the past, present and future Traditional Custodians and Elders of this nation and the continuation of cultural, spiritual and educational practices of Aboriginal and Torres Strait Islander peoples.

Aboriginal and Torres Strait Islander peoples should be aware that this website contains images or names of people who have passed away.