Register

Filling out this form does not guarantee an appointment. Our reception staff will be in touch to advise whether we are able to offer you an appointment or require further information.

Please note: We are a private billing practice and fees apply to all appointments. We do not offer bulk billing and our services are not covered by Work Cover or TAC.

We are not a crisis management resource and we are unable to provide same day support or advice. Resources for urgent care can be found at the bottom of this page.

Are you registering for yourself or a child?

Adult Registration

If your gender is not listed above, please let us know your preference

If your pronouns are not listed above, please let us know your preference

Maximum 250 characters

Please note that Bellarine Psychology does not provide reports or advice for legal matters.

Therapy Services Required

Assessment Services Required

Please ask your GP to send the referral to us at reception@bellarine-psychology.com.au

Maximum length 250 characters

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Child Registration

Please note that for a child, both parents/legal guardians must provide consent. If there are extenuating circumstances, please contact us to discuss.

If your child's gender is not listed above, please let us know your preference

If your child's pronouns are not listed above, please let us know your preference

Maximum 250 characters

Please note that Bellarine Psychology does not provide reports or advice for legal matters.

Therapy Services Required

Assessment Services Required

Please ask your child's GP to send the referral to us at reception@bellarine-psychology.com.au

Javascript must be enabled to submit this form.

If you're really struggling right now, contact one of the following help lines:

If you require urgent mental health support please contact the regional mental health service:

In an emergency please contact 000

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