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Ubuntu Wellness Clinic - Intake Form

Provides access to our Clinic
Fee:   $80


Setup of an account as a client of The Ubuntu Wellness Clinic with your details provided to us.
Initial one on one online phone consultation with one of our consultants.
Nutritional Guidelines and 
additional support information.

* We highly recommend after your first online consultation that you book a Follow Up consultation – booked approx 3 weeks after your initial consultation


Please read instructions carefully for the Intake form below and answer the questions as best you are able.

Once you make the payment (at the end of the intake form below) you will receive a payment submission confirmation email. 


Please make sure you check your spam/junk/promotions folder for your confirmation email.

It is imperative once your form is complete for you to please take the time to read through the Intake Form Nutritional Guidelines and Support Information, preferably with loved ones or carers who will be assisting you. This information will be provided to you directly after payment and also via a link in the email you receive confirming payment.

Once your Wellness Clinic Intake Form is complete and submitted to us you are then entered in our system as a client.  One of our consultants reads your case particulars and creates a comprehensive program for you including: diet, health, lifestyle, natural medicine recommendations and where to purchase medicines.

Please note the $80 fee is non-refundable, so please ensure you complete the full intake process. 

Once the Intake Form process is complete, you will receive a phone call to book an appointment with one of our consultants as soon as possible. The above process usually takes no more than around 5 working days.

We look forward to sharing your journey to wellness.

If you experience any difficulties, please either email or call us for assistance:


Tel: 02 4926 1881 

10am-5pm Monday to Friday

The Ubuntu Team.      

1. & 2. Please first Signup to our website and create a free account using your email address and create your own private password.

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