child psychologist

Information, Consent, and Payment Form

Please complete the below form to confirm your first appointment booking.  Appointment payments are made via a secure banking portal with NAB (you will be re-directed to this NAB page when you submit this form). In order to confirm your card details, a $1 deposit will be processed which is then taken off the first session fee. No other payment methods are possible and your card will be stored and used for all future session payments. If this form is not working or you have any questions please call 0410974435 or email us at