Book an appointment

Appointment Request Form

To request an appointment online, please complete the form below.

We will contact you to confirm your appointment.
If you do not hear from us, either by phone or email, within 1 working day of sending your online request,
please contact us on 1800 056 076.

Please remember to complete all fields marked with *

Choose your appointment
Preferred date: *
Pick date
 Preferred time: *
(Click on the calendar icon to pick a date) (Enter preferred time, e.g. 11:00am)
Your location
Enter your location: *
City:
State:
(E.g. City: Brisbane, State: QLD)
Enter your details
Your name: *
Contact number: *
Your e-mail: *
Your date of birth: (day/month/year e.g. 11/08/1985)
Other details
Do you wish to book an appointment as part of your company's EAP program?
Please choose:
Do you wish to book an appointment as a private client?
Please choose:
Comments
Enter any comments:
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