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New Client Information

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Please complete and submit before attending your appointment. Call us on (08)6160 6000 with questions.

Name *
Name
Address
Address
Do you have a doctors referral?
Please ensure you bring your doctors referral/mental health care plan to your appointment. Clients who are not appropriately referred may not be eligible for a Medicare benefit.
Do you have a Centrelink Concession Card?
Credit / EFTPOS Card Details *
Credit or EFTPOS Card details are required to secure your appointment, please provide below:
Month / Year
I have read and understood the cancellation policy below.
By clicking submit you agree that this information is correct and accurate.

Cancellation Policy: If, for some reason you need to cancel or postpone the appointment, please give at least 24 hours’ notice and on the previous Friday for Monday consultations (or Tuesday consultations after a public holiday).  If this notice is not given then you will be charged the FULL consult fee plus GST regardless of receiving/not receiving a text reminder. Medicare rebates are not claimable if you do not attend or give enough notice of cancellation.