child psychologist

Information, Consent, and $180 Payment Form

Please complete the below form to pay your $180 appointment fee via a secure banking portal with NAB (you will be directed to this payment page when you submit the form).  All future appointment payments will be debited from this card you provide unless you provide us with an alternative card. No other payment methods are possible. If this form is not working or you have any questions please call 0410974435 or email us at info@southernhighlandspsychology.com.au