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Request an Appointment

Welcome to Neo Psychology

You can make a secure and confidential appointment request by filling out this form. In doing so you will receive an email confirming your successful place on the waiting list. Once you have submitted your request, you can expect our Intake Co-ordinator to contact you shortly. Only our Intake Co-ordinator and consulting Psychologists will have access to any of this information.

 

If you prefer not to use this online request service, you can request an appointment with our intake co-ordinator by phoning 1300 303 160.

– CONFIDENTIAL –

    * Please describe the main issue, problem or need

    The person wishing to see a psychologist?Parent/Carer of the person to see the psychologist?Professional making a referral?

    Does the client know you are referring them?

    YesNo

    Client Details














    Referrer Details










    *Please describe the main issue, problem or need

    *Please indicate which category this best fits into?

    Educational / academic assessmentLearning problems / disorderBehavioural problemsClinical diagnosisVocational assessment & career issuesReport for third partyIndividual counselling / therapyCouples counselling / therapyFamily counselling / therapyParent counsellingGroup counselling / therapyExecutive or life coachingPost‑natal depression or stressSchool issuesBullyingPTSD / TraumaDepressionAnxiety or phobiasADHDSelf‑harm / Suicide issuesOther

    * Do you have a goal for this referral?

    Do you have an preference for the gender of your psychologist?

    First availableMaleFemale

    * Do you have a preferred time/s?

    No preferenceMorningLunchtimeAfternoonAfter Hours

    * Do you have a preferred day/s?

    No preferenceMonTueWedThuFriSat

    * Are you seeking Medicare rebates?

    YesNo

    You can only claim Medicare rebates after a referral has been made. Please refer to information about Medicare that will appear on the page after you submit your request.

    Do you have a medical referral from GP/Psychiatrist/Paediatrician under a ‘Mental Health Care Plan’?

    YesNo

    * How did you hear about us?


    Any other details you'd like us to know?

    I agree to the terms and conditions listed here

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