Contact Form

Use this form to enquire about diagnostic assessments, professional training/supervision, group therapy, ask a question before starting individual therapy, or to provide our clinic with feedback.

If you are ready to start therapy now, the quickest way is to book directly here.

Name(Required)

First Last

Email(Required)

Mobile(Required)

How did you hear about us?(Required)

More information

Please provide more information on how you heard about us e.g if a school please provide name of the school

Purpose(Required)

Please provide as much information about your enquiry below(Required)

Please note that Minds & Hearts does not have the capacity to support acute risk and provide crisis care support. More information on crisis situations can be found here

What funding method will you be using at Minds & Hearts?

Medicare

NDIS Plan Managed

NDIS Self Managed

Private Health

Third Party

Paying Privately

New Client

Have you/the client or any carers been involved in past, current, or upcoming legal proceedings?(Required)

(e.g; court matters, insurance claims/disputes, Centrelink/NDIS disputes, financial/work arrangements, family court proceedings, mandated custody arrangements, DVO, etc.)

Thank you for contacting Minds and Hearts, unfortunately we are unable to provide services where court related matters are involved. Professionals experienced with court related matters can be found via services listed on our Referral Assistance page. We sincerely apologise that we are unable to assist you in this instance.

Mobile Phone(Required)

Date of Birth(Required)

What funding method will you be using at Minds & Hearts?

Medicare

NDIS Plan Managed

NDIS Self Managed

Private Health

Third Party

Paying Privately

Will you be travelling to the clinic from interstate or internationally?(Required)

Please provide a description of the current problem(s) that you would like Minds & Hearts to help you with:(Required)

Please note that Minds & Hearts does not have the capacity to support acute risk and provide crisis care support. More information on crisis situations can be found here

Please provide information about how the problem(s) above might be impacting day-to-day functioning:(Required)

For example: how might the problems impact daily life, emotional functioning, social functioning, school, work, family, or other domains of functioning.

Group Therapy

Groups(Required)

Eligible Particiants would be 21-years or older with a diagnosis of autism and a desire to reduce cycles of burnout. For brand new clients of the clinic a one-hour screening appointment is required to confirm suitability for the group. Group sessions can be covered by Medicare Mental Health Care Plan from your GP or Psychiatrist that specifies Group Therapy - M&H Burnout Group as part of the treatment recommendations

Availability

Monday

Tuesday

Wednesday

Thursday

Friday

Please tick all days available to attend and then the relevant time slots.

Availability

Wednesday - 4 till 5.30pm

Please tick all days available to attend and then the relevant time slots.

Monday Availability

Morning 10-12pm

Afternoon 1-3pm

Last Afternoon 4-6pm

Tuesday Availability

Morning 10-12pm

Afternoon 1-3pm

Last Afternoon 4-6pm

Wednesday Availability

Morning 10-12pm

Afternoon 1-3pm

Last Afternoon 4-6pm

Thursday Availability

Morning 10-12pm

Afternoon 1-3pm

Last Afternoon 4-6pm

Friday Availability

Morning 10-12pm

Afternoon 1-3pm

Last Afternoon 4-6pm

Parent's Name(Required)

First Last

Name(Required)

First Last

Child's Name(Required)

First Last

Child's Date of Birth(Required)

Date of Birth(Required)

Parent Contact Mobile(Required)

Parent Contact Email(Required)

Diagnosis(Required)

Questions or Comments

Employment Enquiry

Position/Type of Enquiry(Required)

Other Type of Position/Type of Enquiry

Professional Background

Allied Health Discipline(Required)

E.G. Psychologist, Speech Therapist, Occupational Therapist, Psychiatrist, etc...

Academic Qualifications(Required)

Years of Clinical Experience(Required)

E.G. 0–2, 3–5, 6+

Availability / Interest

Preferred Start Date(Required)

Availability(Required)

E.G. 1–2 days, 3–4 days, full-time, flexible

Area(s) of Interest(Required)

Assessment

Therapy – Individual

Therapy – Couples/Family

Therapy – Groups

Other (Please specify below)

Please select all that apply

Other Area of Interest

Supporting Information

Upload CV/Resume(Required)

Max. file size: 10 MB.

Cover Letter / Message(Required)

Consent

Consent - Info Recruitment Purposes(Required)

I consent to Minds & Hearts storing my details for recruitment purposes(Required)

Consent for Future Opportunties

I would like to be considered for future opportunities if a suitable position is not currently available.



info@mindsandhearts.net

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07 3844 9466

Find Us

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Minds & Hearts
Shop 2/444 Logan Rd
Stones Corner QLD 4120, Australia
07 3844 9466