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Please note:
Fees do not apply to clients in South Western or Central Eastern Sydney or Nepean Blue Mountains (PHN funded service)
Information is collected in accordance with the privacy policy on our website, including deidentified information being provided to PHNs for PHN funded services
Certain services may be bulk billed (including the interview of a person other than the patient – 92458, 92459 or 92460)
Medicare rebate for eligible patients.
Service Fees
Full Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Date of Birth
*
/
Day
/
Month
Year
Date
Medicare Billing Acknowledgment
*
I recognise that instances of repeated billing may occur, and I affirm that I am fully aware of and understand this possibility.
Signature
*
Submit
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