Please note – Both telehealth and face-to-face appointments are available. Clients who have previously seen Helena are also welcome to re-engage at any point.

If you are in the above categories, and would like to submit an application to become a new client, this is our process:

Step 1: Complete the Appointment Request Form below (once you have familiarised yourself with relevant information on the website to ensure that the services we offer are an appropriate “fit” for your needs).

Step 2: Ask your GP to fax or email your referral to us at 03 9077 1115 (if you have a referral for medicare-subsidized services).

Step 3: We will then require you to complete a consent form, and provide billing and medicare card details.

Please note we cannot offer you an appointment time until you have completed all three steps of the intake process.

Please ensure that you complete all required form fields, otherwise the form will not submit, and we will not receive your appointment request. NOTE WE REQUIRE COMPLETION OF THE APPOINTMENT REQUEST FORM BELOW REGARDLESS OF WHETHER YOUR GP HAS, OR INTENDS TO SEND THROUGH A REFERRAL.

Note: this practice does not offer bulk billing. We are able to offer partial Medicare rebates to anyone with a Mental Health Care Plan or an Eating Disorders Plan. All out-of-pocket costs associated with Medicare-subsidised services count toward the Medicare Safety Net. If you would like up-to-date information on fees and rebates prior to submitting an appointment request, please email: helena@psychologyonkew.com.au

NEW CLIENT APPOINTMENT REQUEST FORM

First name*
Last name*
Address
Street Address * Address Line 2 City * State * Post Code * Country *
Email address*
Age*
Mobile phone number*
Date of birth*
MM slash DD slash YYYY
Briefly describe why you are coming, and what you would like assistance with (including any formal diagnoses if known)*
Do you have a current Mental Health Care Plan or an Eating Disorders Plan?*
Please note - you will not be eligible for medicare rebates UNLESS you have a Mental Health Care Plan or Eating Disorders Plan
If you are coming under a medicare-based plan, who is the referring medical practitioner, and what is the name of the referring Medical Practice?
Are there any constraints (financial or otherwise), on the number of sessions you can attend?*
Weekly appointments are recommended in the early stages of the treatment process. The frequency of appointments recommended after this time will depend on the nature of the presenting difficulties.
Preferred day(s) and time(s) for appointments
Please note that after-school times are limited due to high demand. If you are only able to attend appointments outside of the hours of 8am to 4pm you may be required to wait longer depending on our current capacities.
What kind of psychological service are you seeking?*
Are you able to attend appointments between the hours of 8am and 4pm?*
Please note we are only able to accommodate a certain number of clients at times after 4pm.
Is there any other information that it is important that we know?
Name of Emergency Contact Person*
(NB: This person would ONLY be contacted in the unlikely event of an acute emergency)
Mobile phone number of Emergency Contact*
Nature of relationship with the Emergency Contact*
Do you have any quick questions that you would like answered before your 1st appointment?
How did you hear about this practice?*
i.e., GP, internet search, APS Find a Psychologist, Healthshare, word of mouth, another psychologist, dietitian, psychiatrist, website etc
I am aware that this practice does not bulk bill, and that medicare rebates only cover a portion of the total fee(s).*
- Yes
I have double checked that I have completed ALL FIELDS marked with a * in the above form.*
PLEASE NOTE: we will not receive your form unless you complete ALL required fields marked with a *. You will know your form has been received if you are directed to a THANK YOU page immediately after submitting the form. If you do not hear from us after two business days, please email helena@psychologyonkew.com.au to check that we have received your form.
- Yes

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Crisis and Emergency Support

Please note that this practice is unable to provide crisis or emergency support.

In the event of a psychiatric emergency, please contact the Psychiatric Triage service on 1300 558 862

Other emergency and crisis services that can be accessed 24 hours a day, 7 days a week include:

Police or Ambulance 000
Nurse on Call 1300 60 60 24
Victorian Poisons Information Centre 13 11 26
Your local hospital Emergency Department
Lifeline 13 11 14
Suicide Help Line 1300 651 251
Kids’ Help Line 1800 551 800
Mens’ Helpline 1300 789 978
Parentline 13 22 89