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Therapy Bookings & Enquires

Start with your details

First Name

Last Name

Phone

Who are you booking for?

What is your relationship to the client?

First Name

Last Name

Client Email

Client Date of Birth

Date of Birth

Preferred Psychologist

Preferred Appointment Format

Preferred Appointment Frequency

How many appointments would you like book initially?

Will you initially be using one of the following rebate/funding options?

If you have obtained your Medicare referral already, please upload it here

Choose File

Please briefly share why you are engaging

Assessment Bookings & Enquires

Starting with your details

First Name

Last Name

Phone

Who are you booking for?

What is your relationship to the client?

First Name

Last Name

Client Email

Client Date of Birth

Date of Birth

What are your reasons for seeking an assessment?

What assessments have you previously completed, if any?

Preferred Psychologist

Will you be using one of the following rebate/funding options?

If you have obtained your Medicare referral already, please upload it here

Choose File

Please briefly share what prompted you to seek an assessment

Combined Therapy and Assessment Bookings & Enquires

Combined Bookings & Enquires

Starting with your details

First Name

Last Name

Phone

Who are you booking for?

What is your relationship to the client?

First Name

Last Name

Client Email

Client Date of Birth

Date of Birth

General Enquires

	Monday	Tuesday	Friday
8:00 - 10:00
10:30 - 12:30
1:00 - 3:00
3:30 - 4:30

	Monday	Tuesday	Thursday	Friday
8:00 - 10:00
10:30 - 12:30
1:00 - 3:00
3:30 - 4:30

	Thursday	Friday
8:00 - 10:00
10:30 - 12:30
1:00 - 3:00
3:30 - 4:30

	Thursday	Friday
8:00 - 10:00
10:30 - 12:30
1:00 - 3:00

	Monday	Tuesday	Friday
8:00 - 10:00
10:30 - 12:30
1:00 - 3:00
3:30 - 4:30

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Your time is valuable. These forms help us address your needs from the start, reducing your up-front energy cost.

We aim to respond within 2 business days.

Quick links

Important information

APPOINTMENT Availability

Phone:	We do not have a contact number; please email us.
Fax:	(03) 7000 5010
Email:	hello@youniquepsychology.com.au
Location:	203 Poath Road, Murrumbeena, VIC 3063

Fill.Send.Hear from us.

Your time is valuable. These forms help us address your needs from the start, reducing your up-front energy cost. We aim to respond within 2 business days.

Fill.
Send.
Hear from us.

Your time is valuable. These forms help us address your needs from the start, reducing your up-front energy cost.

We aim to respond within 2 business days.