Book an appointment

Please fill in the form below to book an appointment with The Swinburne Psychology clinic for a consult or treatment.

First name *

Last name *

Contact number *

Postal address *

Postcode *

Email address *

Preferred Pronouns * (this helps us understand the best way to address you)

Date of Birth *

Fee scale * (Consultation fees for individual counselling are set on a sliding scale and calculated at a rate of $1.00 per hour for every $1,000 of family income, with a minimum fee of $20 and a maximum fee of $80 per consultation. An additional $10 administration fee is required for the first consultation)

Reason for appointment *

Swinburne Psychology Clinic is dedicated to clinical teaching and research that enhances clinical practice. We may get in touch to ask whether you would be interested in participating in research we run through the clinic. You will always have the option to say no. Would you like to be contacted about research? * No Yes

Where did you hear about the Swinburne Psychology Clinic?

When is the best time for us to call you back between 9:00am and 5:00pm? *

Any comments you wish to make?