Appointments & Referrals for New Clients

We understand that sometimes it’s hard to talk about things over the phone. To book online simply fill in the form below and hit submit. We will be in contact within 2 business days to match your needs with a suitable clinician and organise an appointment time. If you are en existing client please book online here. Be mindful that when booking online you choose the correct clinician name from the drop down menu.

Please bring your referral along to your first appointment.

Alternatively, referrals can be emailed to admin@melbournewellbeinggroup.com.au or faxed to (03) 9957-2278.

Patient Details

First Name

Last Name

Preferred Phone Number

(###)

###

####

Email Address

Referring Doctor Details

First Name

Last Name

Referring Doctor Provider Number

Date of Referral

YYYY

Date of Mental Health Care Plan

If applicable

YYYY

Reason for Referral

Referring Doctor Phone Number

(###)

###

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Our Office

Level 2 - 613 Canterbury Road

Surrey Hills VIC 3127.

Ph: (03) 9882-8874

Fax: (03) 9957-2278