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Brisbane’s Expert Psychology Services for Children, Adolescents & Adults (07) 3801 1772 (Loganholme) or (07) 3823 2230 (Capalaba)

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Types of Referrals
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Testimonials
Contact Us
Psychology Blog
- Awareness Weeks
Join Our Team

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Please complete the details below and one of our team members will be in contact to organise your visit with us. Talk with you soon.

Doctor Details (If uploading a referral, please complete only mandatory fields below)

Name *
Email
Medical Centre *
Phone Number
Medicare Provider Number
Address
Fax

Patient Details

First Name
Surname
Email
Preferred Contact Number

Referral Details

Date of Referral
Date of Mental Health Care Plan
Preferred Practice Location *
LoganholmeCapalaba
Reason for Referral *
Type of Referral
GP Mental Health Care PlanPsychological TherapiesWorkcoverDepartment of Veteran AffairsPrivate Insurance (e.g. Alliance, Suncorp etc)Employee Assistance ProgramAutism InitiativeDon't Know / UnsureBetter Start for Children with Diasabilites InitiativePrivateOther
Private Health Insurance
YesNo
Exisiting or New Client
Exisiting ClientNew Client
How did you hear about us? *
Instructions
File Upload Please feel free to upload your direct referral here

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Contact Details Loganholme Practice
P: (07) 3801 1772
Address:
Ground Level, Unit 4A
16–18 Beenleigh-Redland Bay Rd,
Loganholme QLD 4129

Capalaba Practice
P: (07) 3823 2230
Address:
Unit 7
29 Mt Cotton Rd,
Capalaba QLD 4157

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