Request an Appointment

Need Help?

Complete this form to request an appointment with one of our Therapists.

A member of our friendly team will be in contact.

First Name

Last Name

D.O.B

Email

Phone

Are you an existing client?

Yes No

Do you have private health insurance?

Yes No

Do you have a mental health plan from your GP?

Yes No

Please attach a copy of your Mental Health Care Plan

Which psychological service are you interested in?

Individual Therapy Session Educational Assessment / Testing Other

Location

Preferred appointment time

AM PM

Do you have a preferred Therapist?

Scroll to Top

Your request has been sent. We’ll be in touch