7 Locations: East Melbourne, Melbourne CBD, Richmond, Canterbury, Mill Park, South Yarra & Sunshine

Call Us Now:
(03) 9419 7172

Make an appointment and psychologist / psychiatrist referral service

Make an appointment with a psychologist or psychiatrist; and psychologist / psychiatrist referral service

Please complete the form below with your details. Whilst the questions below are optional, by answering in full you will assist us to match you to the most appropriate practitioner for your needs. Once we have received your details our intake team will contact you with further details about the most appropriate course of action for your circumstances. Our intake team are also available to speak with you to answer any queries you have and help you decide which practitioner is best suited to your needs.


Please tick the services which are of interest to you?

Depression Post-natal depression
Anxiety Post-traumatic stress
Sleep issues, insomnia Child and adolescent development
Lifestyle issues Stress
Eating disorders Gambling and addictions
Grief and loss Bipolar disorder
Relationship counselling Pain management
Transition counselling Social avoidance
Shame Self-esteem
Alcohol use Drug use
Sexual issues Custody disputes
Family of origin issues Anger management
ADHD Weight management
Autism / Aspergers Hypnosis
Workplace issues Learning and development assessment

Do you have a preference to see a particular practitioner?

1st preference
2rd preference

Do you have a preference for the location(s) you attend?

East Melbourne
Eastbourne House, 62 Wellington Parade, East Melbourne 3002
Melbourne CBD
Queen Victoria Building, 23 QV Terrace, 292 Swanston Street, Melbourne 3000
Surrey Hills
174 Union Road, Surrey Hills 3127
Mill Park
20 Civic, Drive Mill Park 3082
South Yarra
Baker IDI Heart & Diabetes Institute, Level 4, 99 Commercial Rd , Melbourne 3004 (in the South Yarra precinct)
324 Hampshire Road, Sunshine 3020
Victoria Gardens Shopping Centre, 620 Victoria Street, Richmond 3121

If you have any referrals, reports or other information to send us, you can upload these now (or fax to us on (03) 8678 3880, or bring to your appointment):

  (PDF,DOC,DOCX only, Max. 3MB)

  (PDF,DOC,DOCX only, Max. 3MB)

Name of referring GP (or other practitioner) and suburb if you have a referral:

Please provide any additional useful information to help us match you to the most appropriate practitioner


If you experience difficulty using this form, please click here to email us directly