Skip to content
Brisbane’s Expert Psychology Services for Children, Adolescents & Adults
(07) 3801 1772 (Loganholme) or (07) 3823 2230 (Cleveland)
Facebook page opens in new window
Search:
Psych Professionals
Home
Services
General
Child Psychologist
Asperger’s Counselling
Autism Counselling
Child and Teenage Counselling
ADHD Assessment and Intervention
Relationship Counselling
Trauma Counselling
Grief Counselling
Anxiety Counselling
Depression Counselling
Sexual Abuse Counselling
Eating Disorder Counselling
Cognitive Behaviour Therapy
Group Programs
2017 Kids Groups
School Holiday Groups for Children
Other
Animal Assisted Therapy
Types of Referrals
Mental Health Care Plans
Better Outcomes in Mental Health / ATAPS
Department of Veterans Affairs
Private
Private Insurance & Employee Assistance Programs (EAP)
WorkCover
Autism Initiative
Better Start for Children with Disability Initiative
Our Team
Psychologist Team
Child & Adolescent Psychologist Team
Client Relationship Team
FAQ
Testimonials
Contact Us
Psychology Blog
Awareness Weeks
Join Our Team
Home
Services
General
Child Psychologist
Asperger’s Counselling
Autism Counselling
Child and Teenage Counselling
ADHD Assessment and Intervention
Relationship Counselling
Trauma Counselling
Grief Counselling
Anxiety Counselling
Depression Counselling
Sexual Abuse Counselling
Eating Disorder Counselling
Cognitive Behaviour Therapy
Group Programs
2017 Kids Groups
School Holiday Groups for Children
Other
Animal Assisted Therapy
Types of Referrals
Mental Health Care Plans
Better Outcomes in Mental Health / ATAPS
Department of Veterans Affairs
Private
Private Insurance & Employee Assistance Programs (EAP)
WorkCover
Autism Initiative
Better Start for Children with Disability Initiative
Our Team
Psychologist Team
Child & Adolescent Psychologist Team
Client Relationship Team
FAQ
Testimonials
Contact Us
Psychology Blog
Awareness Weeks
Join Our Team
Expression of Interest – Groups
You are here:
Home
Expression of Interest – Groups
Expression of Interest Registration Form
Details of Young Person
Name & Surname of Parent/Carer
*
Name & Surname of Young Person
*
Best Contact Number of Parent/Carer
*
Email
*
Age of Young Person
*
Gender
*
Male
Female
Post Code
Please list the post code of your home address.
Group Details
Group You Would Like To Register For
*
Cool Connections (ages 9-14)
Resilient Minds (ages 14-18)
Social Communication & Conflict Management (ages 9-14)
Previous Counselling with The Psych Professionals
Is your child/teenager a current or previous client of our practice?
Current
Previous
No
How did you hear about the Groups?
My Psych Professionals Psychologist
Notice in The Psych Professionals Waiting Room
My GP
Facebook
Google
Family or Friends
Other
Previous Counselling
Has your child/teenager attended counselling with a Psychologist during the last 6 months?
Yes
No
Diagnosis, Concerns, Challenging Behaviour or Presenting Problem:
If your child/teenager has received a mental health diagnosis from either your GP/Paediatrician/Psychiatrist/Psychologist, please specific such.
Health Care Card
*
Do you have a current Health Care Card?
Yes
No
Questions or Comments
If you have any additional Questions for us or would like to make any Comments not covered by this form, please list such.
Verification
Please enter any two digits
*
Example: 12
This box is for spam protection - <strong>please leave it blank</strong>:
Go to Top