HEART Collective Provider Application
ACC ISSC APPLICATIONS (current contract)
Due to the current ACC ISSC contract ending 30 November 2024, HEART Collective are not accepting applications under the exisiting contract for NEW ACC Providers. Applications for new providers under the new contract reopen February 2025.

We are still accepting applications from Providers (Counsellors, Psychiatrists, Psychologists, Psychotherapists and Social Workers provding counselling) with a minimum 12months experience as an ACC Provider, for the current ACC ISSC Service contract - closing date for applications is 31 July 2024. You need to apply througn Business Connect to be an ACC Provider and complete this form.

Applications for ACC Sensitive Claims Service Contract 2024 open to Named Service Providers (Counsellors, Psychiatrists, Psychologists, Psychotherapists and Social Workers providing counselling) with minimum 12 months experience as ACC Provider - closing date for applications is 31 July 2024.

Please see below if you are interested in providing counselling services for HEART Collective under our other contracts

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Email *
This form will be sent to: admin@heartcollective.co.nz
Founder & Lead Therapist: Selena Needham
Organisation: Heart Psychological Assessment & Treatment Services Limited trading as  HEART Collective
Phone: 027 573 5362
PO Box 4208, Hamilton East, Hamilton, 3247
admin@heartcollective.co.nz
Your name *
ACC Provider ID *
If applying for new ACC Sensitive Claims Contract 2024, please confirm you have completed your Provider application through Business Connect https://www.businessconnect.govt.nz/ *
Phone number/s: *
Practice address *
Provider vocation *
Required
Ethnicity *
Modalities you offer *
Required
Qualifications *
How many years post grad experience do you have? *
Expertise, experience and specialty areas of service: This includes area of interest ie: Youth, perinatal *
Private Rate inclusive of GST (for private paying referral enquiries) *
General Availability *
Required
Indicate which contracts you are interested in working under *
Required
Please indicate what session types you offer *
Required
Can you travel, if yes where? *
Will you be seeing clients at your home address? *
What group(s) are you applying to work with? *
Required
Supervisor Name and Email *
How did you hear about us? *
Contact details of two professional referees (we will not contact them before we speak with you)
Please confirm you have sent your resume or CV, and copies of relevant certificates and qualifications to admin@heartcollective.co.nz: *
Required
A copy of your responses will be emailed to the address you provided.
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