03 9586 8488
intake@dbtclinics.com
MELB - SYD - GC - BRIS - ONLINE
Australian DBT Institute Certified Programs
Australian DBT Institute Certified Programs
DBT Info
What is DBT?
What is RO DBT?
What is Youth-DBT?
What is Carers-DBT?
Stabilisation Approach
Our Services
DBT Group Programs
Individual Counselling
DBT Assist (Online DBT Platform)
Make an Appointment
NDIS Referrals
About Us
Our Fees & Charges
Make an Appointment
NDIS Referrals
Our Locations
Melbourne DBT Service
Gold Coast DBT Service
Sydney DBT Service
Online DBT Service
New Appointment
Privacy Policy
DBT/RO-DBT Consent Form
Appointments
Make an Appointment
Home
Make an Appointment
All referrals are taken through our national intake service!
Intake & Referrals via phone, email, or medical objects
–
NDIS Referral Form
–
General Referrals Form
–
DBT Group Referral Form
– Phone:
03 9586 8411
– Fax:
03 9923 6360
– Email:
intake@dbtclinics.com
– Medical-Objects
referrals to Dr. Peter King (5949971K)
Further information and forms:
– Privacy Policy at DBT Clinic:
Privacy Policy
– Cancellation Policy at DBT Clinic:
Cancellation Policy
–
Consent to Release Information form
(if you would like to have our team communicate with other service providers)
–
Consent to treatment form
–
Telehealth Consent Form
–
Feedback Form
–
Client Registration Form
– Medicare Rebates:
What’s covered by Medicare – Mental health care and Medicare – Services Australia
Referral Form - DBT Clinics
Please enable JavaScript in your browser to complete this form.
Name
*
First
Last
Date of Birth
Email
*
Phone Number
*
Address
GPs Details &/or Psychiatrist Information
Your Current Therapist's Details
If you currently have a Psychologist, Social Worker or Counsellor please provide their details. If you do not have a therapist please type "No current therapist"
Please indicate your requested service(s)
*
DBT Individual Therapy
RO-DBT Individual Therapy
DBT Adult Group (Online DBT)
RO-DBT Skils Class (Online DBT)
DBT Graduate Group (Online)
DBT Carers Group (Online)
DBT Youth Group (Online DBT)
Clinical Assessment
General Counselling
Please indicate your preferred day of the week for a DBT Group/Skills Class
Tuesday @ 7.30pm (DBT)
Tuesday @ 6.00pm (RO DBT)
Thursday @ 6.00pm (DBT)
Please indicate your preferences for Individual Therapy (if you are seeking individual therapy)
Monday appointments
8am-10am appointments
Tuesday appointments
11am-1pm appointments
Wednesday appointments
2pm-4pm appointments
Thursday appointments
5pm-7pm appointments
Friday appointments
8pm-10pm Appointments
Saturday appointments
Any Time of the Day
Any Day of the Week
Choose your preferred days and times for appointments above.
Referral Information (Mental Health Plans, Referral Letters, Crisis Management Plans, Assessments...)
Click or drag files to this area to upload.
You can upload up to 5 files.
If you have any referral information it is always useful to provide this information to support our intake processes.
Further information or Messages
Submit
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