Return to Therapy Intake
Thank you for returning to Mums Matter Psychology. We would like to find out a bit more about your current situation with the purpose of ensuring our specialised perinatal practice is still the best fit for you. This information will be stored securely. Please check your email after submitting this form for the next steps from here.

Please note: Mums Matter Psychology is a perinatal service - if your children are now older than 4yrs and you are not currently pregnant we are unable to continue your treatment.
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Email *
Given Name/s *
Last Name *
Mobile Phone Number *
What is your Date of Birth? *
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YYYY
What State do you live in? *
If your previous therapist is still working at Mums Matter Psychology, would you like to see them again if possible? *
What type of appointments are you interested in? *
Which councils would you be prepared to attend physical face-to-face appointments in?
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Required
Are you interested in attending a after-hours sessions (5pm - 9pm) or Weekends which attract an after-hours fee of $75?  

These spots are available immediately reducing your wait time.

Please note there we don't offer bulk-billed after-hours or weekend appointments and your ongoing appointments will remain after hours. You will not return to a bulk-billed spot.
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What time of day can you attend appointments?
9am - 1pm (Mornings)
1pm - 5pm (Afternoons)
5pm+ (Afterhours)
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Are you interested in before-hours appointments at 7am. These are currently bulk-billed?
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Are you willing to work with a male therapist?
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Have you already attended therapy sessions with another clinician using your Mental Healthcare Plan in 2024?

(You can only access 10 Medicare sessions in a calendar year.)

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How many Mental Health Care Plan sessions under Medicare have you used in 2024? If none, please type 0.
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What phase of the perinatal period are currently in? *
Required
How many weeks pregnant are you or your partner currently (if applicable)?
How old is your child/ren (if applicable)?
What is your current relationship status? *
Who do you currently live with? *
Do you have at least one person who supports you emotionally? *
Who supports you emotionally? *
Have you seen a mental health professional previously other than Mums Matter Psychology? *
When did you last see a clinician at Mums Matter Psychology?
In the past, have you experienced the following? Tick all that apply.
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Required
Please rate your mental health within the last week from 1 (feeling suicidal) to 5 (feeling the best you could feel)
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What are the main reasons you are coming to therapy now? (tick all that apply)
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Required
Which of these have you experienced in the past week? (tick all that apply)
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Required
Do you currently take medication for mental health?
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If yes, what is the medication and what is the dose?
Do you currently use elicit drugs or consume alcohol excessively?
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Are you currently working with any other services?
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Required
Is there anything else you'd like us to know?
A copy of your responses will be emailed to the address you provided.
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