You don't have to explain everything right now.

We'll keep this simple. Just share what Karen needs to get back to you.

This form does not ask you to describe your mental health, diagnosis or trauma.

What should Karen call you?

First name

Your first name is enough. You can add a surname if you like.

How would you like Karen to contact you?

EmailPhone callText messageEither is fine

Email address

Needed if you chose email.

Mobile or phone number

Needed if you chose a call or text.

How would you prefer to meet?

You can change this later.

Mornington practiceTelehealthI'm not sure yet

Is there something you'd like to ask about?

You don't need to know which type of support is right for you. This just gives Karen some context for your enquiry.

Do you have a referral?

You don't need a referral to make an enquiry, and there's nothing to upload here.

YesNoI'm not sure

What kind of referral?

Medicare (from a GP)DVAOther

When usually works best for you?

Choose any that suit. Karen will find a time with you.

Weekday morningsWeekday afternoonsI'm flexible

Anything else about timing? (optional)

If there's anything else you'd like Karen to know, you can add it below. You don't need to explain why you're seeking support.

Optional message (optional)

Sending this enquiry doesn't commit you to an appointment. It simply gives Karen enough information to get back to you.