Psychological and Counselling Services

Psychological and Counselling Services

Online appointment must be made at least 3 working days in advance and subject to availability.If you are having problem using this form, you may call to our appointment direct line at +604-6528997/8667.
Patient's Name (Follow exact name in NRIC or exact name in Passport) *
Email*
example@example.com
Type of Service*

First consultationFollow up appointmentPsychological Wellness ScreeningCognitive Screening TestProactive Lifestyle Screening
Psychological Wellness Screening (PWS) – for aged 18 and above
PWS is a brief, rapid screening that helps you get to know your current mental health condition better. It serves as the first step in taking care of your mental health. During PWS, our mental health professionals will guide you through the process of understanding your mental health condition, learning about the warning signs, pick up adaptive coping skills, and access to credible mental health care services and resources in a safe space with ensured confidentiality.
Cognitive Screening Test (CST) – for aged 18 and above
CST is a rapid screening test that checks how well your brain is functioning. Through CST, you may get to know how well you think, learn, and remember; learn about the warning signs of cognitive changes; and learn on ways to keep your brain healthy as you age.
Proactive Lifestyle Screening (PLS) is a preventive health screening assessment designed to help individuals gain insights into their overall wellbeing. Using advanced camera technology, PLS helps you understand your lifestyle patterns and identify areas that may need extra care - so you can make meaningful, specific changes to support your overall health and wellbeing.

Before the scan, please ensure you meet the suitability requirements. Individuals with pacemakers, a history of heart attack, current or recent menstruation (within 2 days before/after menstruation), or long untrimmed nails may not be suitable for scanning. Following these guidelines helps ensure safe and accurate results.
Kindly check your eligibility before making an appointment with us.
Are you under the Employee Assistance Program (EAP)?*

YesNo
Company name
Employee number

First consultation
Type of visit*

Never seen any consultant in Hospital Lam Wah EeSeen other consultant in Hospital Lam Wah Ee before

EMERGENCY CONTACT DETAIL

Never see any consultant in Hospital Lam Wah Ee
Next of Kin's Name (Emergency Contact Person Name)*
NRIC / Passport No.
Telephone No. / Handphone No.*
Gender*

MaleFemale
Email Address*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Relationship*

Follow up appointment
Preferred Date*

DayMonthYear
Online appointment must be made at least 3 working days in advance and subject to availability.
Preferred Time*

AMPM
NRIC / Passport No.*
Telephone No. / Handphone No.*
Type of visit*

Face-to-faceTeletherapy
I want to make an appointment with*

Clinical PsychologistCounselor

Psychological Wellness Screening
Type of visit*

Never seen any consultant in Hospital Lam Wah EeSeen other consultant in Hospital Lam Wah Ee before

Cognitive Screening Test
Type of visit*

Never seen any consultant in Hospital Lam Wah EeSeen other consultant in Hospital Lam Wah Ee before

Proactive Lifestyle Screening
Type of visit

Never seen any consultant in Hospital Lam Wah EeSeen other consultant in Hospital Lam Wah Ee before

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Psychological and Counselling Services

First consultation

PERSONAL DETAILS

EMERGENCY CONTACT DETAIL

PERSONAL DETAILS

Follow up appointment

Psychological Wellness Screening

Cognitive Screening Test

Proactive Lifestyle Screening