Request an Appointment

If you are registering a child/adolescent, please provide the child/adolescent's name and date of birth and your details (guardian details) below.

First Name *

Last Name *

Birth Date *

Street *

Postcode *

City *

Details Legal Guardian (when registering a child/adolescent)

First Name Guardian

Last Name Guardian

Date of birth Guardian

E-Mail *

Telephone Number *

Family Doctor *

Health Insurance Provider *

Which of the following services would you like to request? (Please explain in more detail under “My request”) *

Psychotherapy (covered by basic health insurance)

Psychological counselling (self-paid, but there are still treatment places available)

ADHD assessment (ADHD = Attention Deficit Hyperactivity Disorder)

ASD assessment (ASD = Autism Spectrum Disorder) – we only offer this assessment for children/adolescents

ADHD coaching

Bio/Neurofeedback

Marte Meo Counselling

Parental/parenting advice

My request

I agree to the privacy policy *