Doctor Referral

Do you need support in managing your patients’ mental health concerns? Let us help you.

Submit your patient referrals either,
a. Psychologist Referral – via uploading the referral document; alternatively you can email, fax, or send it along with the patient
or b. Psychiatrist Referral – filling in the online form.

Alternatively, you can email, fax, or send it along with the patient.

Click or drag a file to this area to upload.
1Doctor Details
2Patient Details
3Addtional Information

Referrer Details

The above signature field must be signed by the referring GP/Specialist. If completing your referral on a PC or laptop, please sign the signature field by using your mouse, mousepad or stylus; by tablet or smartphone please sign by using your stylus or finger.

Patient Consent

We are here for you

Get in touch to see how we can help you.