Request an Appointment

Appointments are available Monday to Saturdays.
Please enter your details below to submit a request.

First Name: *

Last Name: *

Preferred Name (If applicable)

Pronouns (Optional)

Email Address: *

Phone Number: *

Preferred Clinician (if applicable)

Preferred Location (if applicable)

Preferred Appointment Date

New or Existing Client? *

Your preferred appointment time:

Preferred contact method *

Reason for Appointment: *

We will be in touch with you as soon as possible to organise an appointment

If your situation is urgent or out of hours please contact the following:

Lifeline Australia - 13 11 14 - Crisis Support and Suicide Prevention

Emergency Services - 000